Individual provider Active NPI

Iniko Zevon Sallee, APRN/CNM

  • Advanced Practice Midwife
  • Lexington, KY
National Provider Identifier
1053892448
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
3012613 Issued in KY
Practice address
1720 Nicholasville Rd Ste 702
Lexington, KY 40503-1489
Phone
(859) 264-8811
Fax
(859) 264-8822
NPI assigned
Aug 24, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3012613 KY
Advanced Practice Midwife 367A00000X 3012613 KY Primary

Addresses

Primary practice location

1720 Nicholasville Rd Ste 702
Lexington, KY 40503-1489

Mailing address

1720 Nicholasville Rd Ste 702
Lexington, KY 40503-1489
Phone (859) 264-8811

Other practice location 1

1775 Alysheba Way Ste 180
Lexington, KY 40509-2480
Phone (859) 264-8811

Other identifiers 1

IdentifierTypeStateIssuer
7100556430MedicaidKY

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180921001737 KY Practitioner - Certified Nurse Midwife (CNM) 1759632227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1720 Nicholasville Rd
Suite 702
Lexington, KY 40503-1489
Phone (859) 264-8811

615 E Brannon Rd
Suite 200
Nicholasville, KY 40356-7919
Phone (859) 264-8811

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
3012613KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Healthcare System, Inc Past Accepting new patients
Obstetrics & Gynecology of Indiana, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: iniko.sallee@axia.eclinicaldirectplus.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1053892448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 NICHOLASVILLE RD STE 702",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031489",
            "telephone_number": "859-264-8811",
            "fax_number": "859-264-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 NICHOLASVILLE RD STE 702",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031489",
            "telephone_number": "859-264-8811",
            "fax_number": "859-264-8822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 Alysheba Way Ste 180",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405092480",
            "country_code": "US",
            "telephone_number": "859-264-8811",
            "fax_number": "859-264-8822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SALLEE",
        "first_name": "INIKO",
        "middle_name": "ZEVON",
        "credential": "APRN/CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3012613",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "KY",
            "license": "3012613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100556430",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.