Individual provider Active NPI

Jeanna Phillips, APRN

  • Pediatric Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1013428150
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
3011755 Issued in KY
Practice address
4117 Browns LN
Louisville, KY 40220-1535
Phone
(502) 452-6337
NPI assigned
Oct 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Pediatric Nurse Practitioner 363LP0222X 3011755 KY
Pediatric Nurse Practitioner 363LP0200X 3011755 KY Primary

Addresses

Primary practice location

4117 Browns LN
Louisville, KY 40220-1535

Mailing address

3938 Gilman Ave
Louisville, KY 40207-2734

Other practice location 1

231 E Chestnut St
Louisville, KY 40202-1821
Phone (502) 629-6000

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
I20180302000959 KY Practitioner - Nurse Practitioner 9133480379 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3011755KYMDCritical Care Pediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children's Medical Group, LLC Pediatrics CurrentSince Aug 1, 2020 Accepting new patients
Norton Children's Medical Group, LLC Pediatrics Current Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Aug 1, 2020 Accepting new patients
Kaplan Barron Pediatrics PLLC PastSince Nov 18, 2025 Accepting new patients
Norton Childrens Medical Group, LLC Pediatrics Past Accepting new patients

Locations

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1013428150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3938 GILMAN AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402072734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4117 BROWNS LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201535",
            "telephone_number": "502-452-6337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "231 E Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021821",
            "country_code": "US",
            "telephone_number": "502-629-6000",
            "fax_number": "502-852-8556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "JEANNA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-16",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "KY",
            "license": "3011755",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KY",
            "license": "3011755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.