Individual provider Active NPI

Stephanie Jane Warren, APRN

  • Family Nurse Practitioner
  • Berea, KY
National Provider Identifier
1073096616
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1081847 Issued in KY
Practice address
245 Prince Royal Dr Ste a
Berea, KY 40403-1471
Phone
(859) 986-0375
NPI assigned
Sep 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1081847 KY Primary

Addresses

Primary practice location

245 Prince Royal Dr Ste a
Berea, KY 40403-1471

Mailing address

245 Prince Royal Dr Ste a
Berea, KY 40403-1471
Phone (859) 986-0375

Other practice location 1

648 University Shopping Ctr
Richmond, KY 40475-2614
Phone (859) 623-1950

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address swarren89058@bhkydirect.com

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
I20181106002259 KY Practitioner - Nurse Practitioner 6406100601 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
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)

648 University Shopping Ctr
Richmond, KY 40475-2614
Phone (859) 623-1950

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

State licenses

LicenseStateTypeSpecialty
1081847KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Apr 29, 2019 Accepting new patients
Rural Health PLLC CurrentSince Oct 3, 2018 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Apr 29, 2019 Accepting new patients

Locations

245 Prince Royal Dr
Ste A
Berea, KY 40403
Phone (859) 200-9640

96 Future Dr
Corbin, KY 40701

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

648 University Shopping Ctr
Richmond, KY 40475
Phone (859) 623-1950

Interoperability endpoints

  • Direct secure messaging: swarren89058@bhkydirect.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": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1073096616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 PRINCE ROYAL DR STE A",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031471",
            "telephone_number": "859-986-0375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 PRINCE ROYAL DR STE A",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404031471",
            "telephone_number": "859-986-0375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "648 University Shopping Ctr",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "KY",
            "postal_code": "404752614",
            "country_code": "US",
            "telephone_number": "859-623-1950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARREN",
        "first_name": "STEPHANIE",
        "middle_name": "JANE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-10",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "1081847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "swarren89058@bhkydirect.com",
            "affiliation": "N",
            "address_1": "648 University Shopping Ctr",
            "city": "Richmond",
            "state": "KY",
            "country_code": "US",
            "postal_code": "404752614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Berea, KY

Sources for this page

Verify at the official NPI Registry.