Individual provider Active NPI

Jennifer Lynne Henderson, FNP

  • Family Nurse Practitioner
  • Elkton, KY
National Provider Identifier
1023532397
Registry record updated Jul 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3011474 Issued in KY
Practice address
810 S Main St
Elkton, KY 42220-8812
Phone
(270) 265-5600
NPI assigned
Jul 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2017

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 3011474 KY Primary

Addresses

Primary practice location

810 S Main St
Elkton, KY 42220-8812

Mailing address

200 Bluebill CT
Shepherdsville, KY 40165-8362
Phone (502) 303-6696

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
I20170911000796 KY Practitioner - Nurse Practitioner 7315210598 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brock Medical, LLCGroup PAC ID 9830354638, 93 clinicians
Fast Pace Kentucky, PLLCGroup PAC ID 0143525998, 213 clinicians

Practice addresses (Care Compare)

2955 Fort Campbell Blvd
Hopkinsville, KY 42240-4901
Phone (270) 632-1548

805 S Lincoln Blvd
Hodgenville, KY 42748-1014
Phone (270) 491-2094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3011474KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Kentucky, PLLC CurrentSince Mar 1, 2025 Accepting new patients
Fast Pace Kentucky PLLC Family CurrentSince Mar 1, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Kentucky PLLC CurrentSince Jun 30, 2018 Accepting new patients
Brock Medical, LLC CurrentSince Jun 30, 2018 Accepting new patients
Fast Pace Kentucky, PLLC Past Accepting new patients

Locations

796 W Broadway St
Campbellsville, KY 42718
Phone (270) 572-4933

1475 Nashville Rd
Franklin, KY 42134
Phone (270) 813-1111

230 N Green St
Henderson, KY 42420
Phone (270) 854-3196

805 S Lincoln Blvd
Hodgenville, KY 42748

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

1350 N Main St
Madisonville, KY 42431
Phone (270) 245-2554

115 Tradepark Dr
Ste A
Somerset, KY 42503
Phone (606) 678-5708

Organizations & group practices 7

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": "1501200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501200000000",
    "number": "1023532397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BLUEBILL CT",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401658362",
            "telephone_number": "502-303-6696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 S MAIN ST",
            "city": "ELKTON",
            "state": "KY",
            "postal_code": "422208812",
            "telephone_number": "270-265-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDERSON",
        "first_name": "JENNIFER",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-28",
        "last_updated": "2017-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3011474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, KY

Sources for this page

Verify at the official NPI Registry.