Individual provider Active NPI

Kayla Brooke Creekmur, APRN

  • Nurse Practitioner
  • Hopkinsville, KY
National Provider Identifier
1013549716
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3014115 Issued in KY
Practice address
2955 Fort Campbell Blvd
Hopkinsville, KY 42240-4901
Phone
(270) 632-1548
NPI assigned
Feb 10, 2020
Last updated
Feb 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3014115 KY Primary

Addresses

Primary practice location

2955 Fort Campbell Blvd
Hopkinsville, KY 42240-4901

Mailing address

725 Oak St
Madisonville, KY 42431-2873
Phone (270) 871-4124

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
I20200302000399 KY Practitioner - Nurse Practitioner 2961839006 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

900 Hospital Dr
Madisonville, KY 42431-1644
Phone (270) 825-5800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3014115KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brock Medical, LLC Nurse Practitioner CurrentSince Feb 11, 2020 Accepting new patients
Baptist Health Deaconess Medical Group Inc Nurse Practitioner CurrentSince Jan 3, 2023 Accepting new patients
Fast Pace Kentucky PLLC CurrentSince Feb 11, 2020 Accepting new patients
Baptist Health Deaconess Medical Group Inc Nurse Practitioner CurrentSince Jan 3, 2023 Accepting new patients

Locations

2955 Fort Campbell Blvd
Hopkinsville, KY 42240
Phone (270) 632-1548

1649 Highway 192 W
London, KY 40741
Phone (606) 330-0055

800 Hospital Dr
Fl 2
Madisonville, KY 42431
Phone (270) 326-3900

900 Hospital Dr
Madisonville, KY 42431
Phone (270) 326-3900

900 Hospital Dr
Fl 5
Madisonville, KY 42431
Phone (270) 825-5100

Organizations & group practices 4

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 4

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": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1013549716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 OAK ST",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424312873",
            "telephone_number": "270-871-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 FORT CAMPBELL BLVD",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422404901",
            "telephone_number": "270-632-1548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREEKMUR",
        "first_name": "KAYLA",
        "middle_name": "BROOKE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3014115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopkinsville, KY

Sources for this page

Verify at the official NPI Registry.