Individual provider Active NPI

Shay Lynn Kirk, APRN

  • Family Nurse Practitioner
  • Paducah, KY
National Provider Identifier
1003121393
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3006402 Issued in KY
Practice address
225 Medical Center Dr
Suite 402
Paducah, KY 42003-7914
Phone
(270) 442-0103
Fax
(270) 442-0109
NPI assigned
Aug 11, 2010
Last updated
Aug 19, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3006402 KY Primary

Addresses

Primary practice location

225 Medical Center Dr
Suite 402
Paducah, KY 42003-7914

Mailing address

PO Box 636961
Cincinnati, OH 45263-6961
Phone (513) 981-5130

Other names 1

  • Shay Lynn Robertson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150910002954 KY Practitioner - Nurse Practitioner 6002123825 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Kentucky Specialty Care LLCGroup PAC ID 1456777069, 144 clinicians

Practice addresses (Care Compare)

1532 Lone Oak Rd
Suite 415
Paducah, KY 42003-7943
Phone (270) 442-0103

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Sep 1, 2020 Accepting new patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Sep 1, 2020 Accepting new patients

Locations

1530 Lone Oak Rd
Paducah, KY 42003
Phone (270) 444-2444

1532 Lone Oak Rd
Ste 245
Paducah, KY 42003
Phone (270) 538-5537

1532 Lone Oak Rd
Ste 320
Paducah, KY 42003
Phone (270) 415-3830

1532 Lone Oak Rd
Ste 415
Paducah, KY 42003

225 Medical Center Dr
Ste 402
Paducah, KY 42003
Phone (270) 441-4400

911 Joe Clifton Dr
Paducah, KY 42001
Phone (270) 415-3886

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439942400000",
    "number": "1003121393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636961",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636961",
            "telephone_number": "513-981-5130",
            "fax_number": "513-981-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 MEDICAL CENTER DR",
            "address_2": "SUITE 402",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037914",
            "telephone_number": "270-442-0103",
            "fax_number": "270-442-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRK",
        "first_name": "SHAY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-11",
        "last_updated": "2015-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3006402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAY",
            "last_name": "ROBERTSON",
            "middle_name": "LYNN",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.