Individual provider Active NPI

Jessica M Little, DPM

  • Foot & Ankle Surgery Podiatrist
  • Mayfield, KY
National Provider Identifier
1093093254
Registry record updated Jul 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
00380 Issued in KY
Practice address
1029 Medical Center Cir
Mayfield, KY 42066-1189
Phone
(270) 251-4590
Fax
(270) 251-4591
NPI assigned
Jul 21, 2011
Last updated
Jul 8, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 00380 KY Primary

Addresses

Primary practice location

1029 Medical Center Cir
Mayfield, KY 42066-1189

Mailing address

1029 Medical Center Cir
Mayfield, KY 42066-1189
Phone (270) 251-4590

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140925002390 KY Practitioner - Podiatry 3476773433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Kent State University College of Podiatric Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinelake Physician Practice LLCGroup PAC ID 6800797507, 45 clinicians

Practice addresses (Care Compare)

1029 Medical Ctr Cir
Suite 401
Mayfield, KY 42066-1189
Phone (270) 251-4590

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue283
Removal of skin lesions19
Removal of nail tissue380
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00380KYMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinelake Physician Practice, LLC Current Accepting new patients
Pinelake Physician Practice, LLC CurrentSince Jul 9, 2014 Accepting new patients
Pinelake Physician Practice, LLC CurrentSince Jul 9, 2014 Accepting new patients
Pinelake Physician Practice, LLC Foot & Ankle Surgery Past Accepting new patients

Locations

1029 Medical Center Cir
Mayfield, KY 42066
Phone (270) 251-4100

1029 Medical Center Cir
Ste 401
Mayfield, KY 42066
Phone (270) 251-4590

1029 Medical Center Cir
Ste 401A
Mayfield, KY 42066
Phone (270) 251-4575

1029 Medical Center Cir
Ste 401B
Mayfield, KY 42066
Phone (270) 251-4400

Interoperability endpoints

  • Direct secure messaging: jessica.little.1@19475.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404777600000",
    "number": "1093093254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 MEDICAL CENTER CIR",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661189",
            "telephone_number": "270-251-4590",
            "fax_number": "270-251-4591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 MEDICAL CENTER CIR",
            "city": "MAYFIELD",
            "state": "KY",
            "postal_code": "420661189",
            "telephone_number": "270-251-4590",
            "fax_number": "270-251-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "JESSICA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-21",
        "last_updated": "2014-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "KY",
            "license": "00380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mayfield, KY

Sources for this page

Verify at the official NPI Registry.