NPIMap

Individual provider Active NPI

Melony Jill Jaggers, APRN

  • Primary Care Nurse Practitioner
  • McDaniels, KY
National Provider Identifier
1093339772
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
57168 Issued in KY
Practice address
9798 Ky-259
McDaniels, KY 40152-7127
Phone
(270) 902-4411
NPI assigned
May 29, 2020
Last updated
May 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 57168 KY Primary

Addresses

Primary practice location

9798 Ky-259
McDaniels, KY 40152-7127

Mailing address

1011 Old Highway 60
Hardinsburg, KY 40143-2519
Phone (270) 580-2250

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
I20200629001402 KY Practitioner - Nurse Practitioner 9739501321 Reassigns benefits to 2 organizations

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
PT Pros, IncGroup PAC ID 0143139337, shared by 14 NPIs, 263 clinicians
Breckinridge Health, Inc.Group PAC ID 0941106454, 14 clinicians

Practice addresses (Care Compare)

201 S Main St
Leitchfield, KY 42754-1425
Phone (270) 230-1729

9798 S Hwy 259
McDaniels, KY 40152-7227
Phone (270) 902-4411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57168KYMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Breckinridge Health, Inc CurrentSince Jul 1, 2020 Accepting new patients
Breckinridge Health Inc CurrentSince Jul 1, 2020 Accepting new patients
Breckinridge Health Inc Past Accepting new patients

Locations

1011 Old Highway 60
Hardinsburg, KY 40143
Phone (270) 756-7000

9798 S Highway 259
Mc Daniels, KY 40152
Phone (270) 756-6655

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Breckinridge Health, Inc.Hardinsburg, KY, CCN 181319 Hospital Corporate Officer Jul 1, 2021
Breckinridge Memorial Swing BedHardinsburg, KY, CCN 18Z319 Hospital Corporate Director Jul 1, 2021
Breckinridge Health, Inc.Hardinsburg, KY, CCN 183498 Rural health clinic Corporate Director Jan 1, 2023

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 6

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": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1093339772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 OLD HIGHWAY 60",
            "city": "HARDINSBURG",
            "state": "KY",
            "postal_code": "401432519",
            "telephone_number": "270-580-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9798 KY-259",
            "city": "MCDANIELS",
            "state": "KY",
            "postal_code": "401527127",
            "telephone_number": "270-902-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGGERS",
        "first_name": "MELONY",
        "middle_name": "JILL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "KY",
            "license": "57168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDaniels, KY

Sources for this page

Verify at the official NPI Registry.