Individual provider Active NPI

Carlee Mudd, APRN

  • Nurse Practitioner
  • Elizabethtown, KY
National Provider Identifier
1053036632
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3018431 Issued in KY
Practice address
2407 Ring Rd Ste 114
Elizabethtown, KY 42701-5938
Phone
(270) 706-5787
NPI assigned
Oct 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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 3018431 KY Primary

Addresses

Primary practice location

2407 Ring Rd Ste 114
Elizabethtown, KY 42701-5938

Mailing address

143 Jack Dr
Bardstown, KY 40004-2343
Phone (502) 264-2771

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
I20221102003037 KY Practitioner - Nurse Practitioner 2769859891 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2407 Ring Rd
Suite 114
Elizabethtown, KY 42701-5938
Phone (270) 735-1588

Hospital & facility affiliations

  • Baptist Health Hardin Hospital, Elizabethtown, KY, CCN 180012
  • CHI Saint Joseph Flaget Memorial Hospital Hospital, Bardstown, KY, CCN 180025

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Nurse Practitioner CurrentSince Nov 1, 2022 Accepting new patients
Baptist Health Medical Group Inc Nurse Practitioner Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince Nov 1, 2022 Accepting new patients

Locations

2407 Ring Rd
Ste 114
Elizabethtown, KY 42701
Phone (270) 706-5787

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

Organizations & group practices 3

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.

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": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1053036632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 JACK DR",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400042343",
            "telephone_number": "502-264-2771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2407 RING RD STE 114",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427015938",
            "telephone_number": "270-706-5787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDD",
        "first_name": "CARLEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-06",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3018431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.