NPIMap

Individual provider Active NPI

Jeremy Bockelman, APRN

  • Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1063813871
Registry record updated Apr 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3008922 Issued in KY
Practice address
8033 Dixie Hwy
Louisville, KY 40258-1344
Phone
(502) 937-3155
Fax
(502) 935-0743
NPI assigned
Sep 11, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2015

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 3008922 KY Primary

Addresses

Primary practice location

8033 Dixie Hwy
Louisville, KY 40258-1344

Mailing address

PO Box 950202
Louisville, KY 40295-0202
Phone (502) 588-9490

Other identifiers 4

IdentifierTypeStateIssuer
7100330320MedicaidKY
000000893307OtherKYANTHEM-NMA
165891OtherKYSIHO-NMA
50076921OtherKYPASSPORT-NMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141010001969 KY Practitioner - Nurse Practitioner 6901026103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

10798 Dixie Hwy
Louisville, KY 40272-4302
Phone (502) 588-9490

1230 Market St
La Grange, KY 40031-7986

12615 Taylorsville Rd
Louisville, KY 40299-4452

12903 Shelbyville Rd
Louisville, KY 40243-1538
Phone (502) 245-4301

12955 Shelbyville Rd
Suite 2
Louisville, KY 40243-1538
Phone (502) 894-9494

1321 Herr LN
Suite 195
Louisville, KY 40222-4385
Phone (502) 423-7911

2450 Bardstown Rd
Louisville, KY 40205-2123
Phone (502) 459-3991

2470 Bardstown Rd
Louisville, KY 40205-2123

300 High Point CT
Mount Washington, KY 40047-6560

438 Adam Shepherd Pkwy
Shepherdsville, KY 40165-6640

4420 Dixie Hwy
Louisville, KY 40216-2986

7926 Preston Hwy
Louisville, KY 40219-3848

8033 Dixie Hwy
Louisville, KY 40258-1344
Phone (502) 899-6150

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

901 Dupont Rd
Louisville, KY 40207-4644

9340 Cedar Ctr Way
Louisville, KY 40291-4522
Phone (502) 239-8431

9342 Cedar Ctr Way
Louisville, KY 40291-4522
Phone (502) 239-3228

9880 Angies Way
Suite 160
Louisville, KY 40241-2851
Phone (502) 423-9595

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3008922KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Oct 1, 2014 Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner Current Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Oct 1, 2014 Accepting new patients
Pearl Medical Practice PLLC PastSince Jan 31, 2021 Accepting new patients

Locations

8033 Dixie Hwy
Louisville, KY 40258
Phone (502) 937-3154

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Interoperability endpoints

  • Direct secure messaging: jbockelman41616@direct.nortonhealthcare.org

Organizations & group practices 4

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1063813871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 950202",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402950202",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8033 DIXIE HWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402581344",
            "telephone_number": "502-937-3155",
            "fax_number": "502-935-0743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCKELMAN",
        "first_name": "JEREMY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-11",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3008922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100330320",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM-NMA",
            "identifier": "000000893307",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO-NMA",
            "identifier": "165891",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT-NMA",
            "identifier": "50076921",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.