Individual provider Active NPI

Jenna Kay Poteet, APRN

  • Family Nurse Practitioner
  • Bowling Green, KY
National Provider Identifier
1053909317
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3015781 Issued in KY
Practice address
484 Golden Autumn Way Ste 201
Bowling Green, KY 42103-6914
Phone
(270) 781-5111
Fax
(270) 780-0475
NPI assigned
Jan 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1132362 KY
Family Nurse Practitioner 363LF0000X 3015781 KY Primary

Addresses

Primary practice location

484 Golden Autumn Way Ste 201
Bowling Green, KY 42103-6914

Mailing address

201 Park St
Bowling Green, KY 42101-1708
Phone (270) 780-5226

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
I20210204000492 KY Practitioner - Nurse Practitioner 9032523972 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

2724 Nashville Rd
Bowling Green, KY 42101-4000
Phone 2707815111270

Hospital & facility affiliations

  • The Medical Center (Bowling Green) Hospital, Bowling Green, KY, CCN 180013

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1132362KYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Graves Gilbert Clinic PLLC CurrentSince Feb 1, 2021 Accepting new patients
Graves Gilbert Clinic PLLC CurrentSince Feb 1, 2021 Accepting new patients

Locations

484 Golden Autumn Way
Ste 201
Bowling Green, KY 42103
Phone (270) 783-3300

2724 Nashville Rd
Bowling Green, KY 42101
Phone (270) 780-0560

201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229

102C Physicians Blvd
Glasgow, KY 42141
Phone (270) 651-2433

405 S L Rogers Wells Blvd
Glasgow, KY 42141
Phone (270) 479-0260

Interoperability endpoints

  • Direct secure messaging: jennapoteet@ggc.allscriptsdirect.net

Organizations & group practices 2

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 1

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": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1053909317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011708",
            "telephone_number": "270-780-5226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 GOLDEN AUTUMN WAY STE 201",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421036914",
            "telephone_number": "270-781-5111",
            "fax_number": "270-780-0475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POTEET",
        "first_name": "JENNA",
        "middle_name": "KAY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1132362",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3015781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.