Active NPI
Jacquelyn Kirby, APRN
- Nurse Practitioner
- Greenville, KY
National Provider Identifier
1053509729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 5363P
- Practice address
- 480 Hopkinsville St
Greenville, KY 42345-1124 - Phone
- (270) 338-5777
- Fax
- (270) 338-5765
- NPI assigned
- Oct 9, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 5363P | KY | Primary |
Addresses
Primary practice location
480 Hopkinsville St
Greenville, KY 42345-1124
Mailing address
480 Hopkinsville St
Greenville, KY 42345-1124
Phone (270) 338-5777
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000545943 | Other | KY | BCBS |
| 611268014 | Other | FEDERAL TAX ID | |
| 31000458 | Medicaid | KY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- University of Louisville School of Medicine, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
480 Hopkinsville St
Greenville, KY 42345-1124
Phone (270) 338-5777
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5363P | KY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Centers of Western Kentucky, Inc. | Current | Accepting new patients | |
| Community Health Centers of Western Kentucky, Inc. | Current | Accepting new patients | |
| Community Health Centers of Western Kentucky Inc | Past | Accepting new patients |
Locations
480 Hopkinsville St
#2
Greenville, KY 42345
480 Hopkinsville St
Greenville, KY 42345
Phone (270) 338-5777
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Federally Qualified Health Center (FQHC)
- Greenville, KY
- NPI 1306848650
-
- Federally Qualified Health Center (FQHC)
- Greenville, KY
- NPI 1164275491
-
- Federally Qualified Health Center (FQHC)
- Russellville, KY
- NPI 1497302723
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Owensboro Health Muhlenberg Community Hospital
- General Acute Care Hospital
- Greenville, KY
- NPI 1407800436
-
dba Owensboro Health Muhlenberg Community Hospital Home Health
- Home Health Agency
- Greenville, KY
- NPI 1912952599
-
dba Owensboro Health Muhlenberg Community Hospital Coal Miners' Respirator
- Pulmonary Disease Physician
- Greenville, KY
- NPI 1992001044
Hospital
-
dba Owensboro Health Regional Hospital
- General Acute Care Hospital
- Owensboro, KY
- NPI 1285613612
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1191888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576800000000",
"number": "1053509729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "480 HOPKINSVILLE ST",
"city": "GREENVILLE",
"state": "KY",
"postal_code": "423451124",
"telephone_number": "270-338-5777",
"fax_number": "270-338-5765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "480 HOPKINSVILLE ST",
"city": "GREENVILLE",
"state": "KY",
"postal_code": "423451124",
"telephone_number": "270-338-5777",
"fax_number": "270-338-5765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRBY",
"first_name": "JACQUELYN",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-09",
"last_updated": "2019-12-20",
"certification_date": "2019-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "5363P",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "000000545943",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FEDERAL TAX ID",
"identifier": "611268014",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31000458",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, KY
- Kentucky Em-I Medical Services PC
- Kentucky Emergency Room Physicians Inc
- Kentucky Emergency-I Services PSC
- Cecile Diane Killough, OT
- Kindred Nursing Centers Limited Partnership (Kindred Nursing and Rehabilitation-Maple)
- Dennis Knoepfler, M.D.
- Shelby Nicole Latham, M.S., CCC-SLP
- Erynn Deann Leis, MS-SLP
- Susan Leveutte
- Bracken Clay Lewis, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.