Individual provider Active NPI

Jennifer Knuckles

  • Clinical Social Worker
  • Edgewood, KY
National Provider Identifier
1083248827
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
257069 Issued in KY
Practice address
925 Dudley Pike
Edgewood, KY 41017-8120
Phone
(859) 360-3006
Fax
(859) 360-3053
NPI assigned
Mar 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 257069 KY Primary

Addresses

Primary practice location

925 Dudley Pike
Edgewood, KY 41017-8120

Mailing address

925 Dudley Pike
Edgewood, KY 41017-8120
Phone (859) 360-3006

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
I20230630002683 KY Practitioner - Clinical Social Worker 1355700881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
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)

1840 Cumberland Falls Hwy
Corbin, KY 40701-2729
Phone (606) 526-4428

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
257069KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Clinical CurrentSince Jun 1, 2023 Accepting new patients
Bluegrass Behavioral Health Group, LLC Clinical CurrentSince May 17, 2020 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jun 1, 2023 Accepting new patients

Locations

1840 Cumberland Falls Hwy
Corbin, KY 40701
Phone (606) 526-4428

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

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.

NPI Registry JSON

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1083248827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 DUDLEY PIKE",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410178120",
            "telephone_number": "859-360-3006",
            "fax_number": "859-360-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 DUDLEY PIKE",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410178120",
            "telephone_number": "859-360-3006",
            "fax_number": "859-360-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUCKLES",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-02",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "257069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

Verify at the official NPI Registry.