Individual provider Active NPI

Marguerite Vernette McBride, APRN-CNP

  • Family Nurse Practitioner
  • Elizabethtown, KY
National Provider Identifier
1003640921
Registry record updated Sep 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4023719 Issued in KY
Practice address
3040 Dolphin Dr
Elizabethtown, KY 42701-7125
Phone
(270) 765-3488
NPI assigned
Sep 2, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2024

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 4023719 KY Primary

Addresses

Primary practice location

3040 Dolphin Dr
Elizabethtown, KY 42701-7125

Mailing address

PO Box 93295
Cleveland, OH 44193-0028

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
I20241017002845 KY Practitioner - Nurse Practitioner 8123550902 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4023719KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kiosk Medicine Kentucky LLC Family CurrentSince Sep 1, 2024 Accepting new patients
GLK Enterprises, LLC Past Accepting new patients

Locations

3040 Dolphin Dr
Elizabethtown, KY 42701
Phone (270) 370-1240

3039 Breckenridge Ln
Louisville, KY 40220
Phone (502) 451-4555

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1725235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725235200000",
    "number": "1003640921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93295",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3040 DOLPHIN DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017125",
            "telephone_number": "270-765-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRIDE",
        "first_name": "MARGUERITE",
        "middle_name": "VERNETTE",
        "name_prefix": "Dr.",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-02",
        "last_updated": "2024-09-02",
        "certification_date": "2024-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4023719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.