Jessica Lynn Anglin, NP
Individual provider Active NPI Family Nurse Practitioner · Madisonville, KY
NPI 1104438902 · NPPES record last updated Feb 2, 2022
Key facts
- NPI
- 1104438902
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 3014910 (KY)
- Practice address
- 200 Clinic Dr FL 6
Madisonville, KY 42431-1661 - Phone
- (812) 477-7246
- Fax
- (812) 477-7240
- NPI assigned
- Aug 21, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Pain Management Centers of America, PSC
Practice addresses (Care Compare)
1101 Professional Blvd
Suite 100
Evansville, IN 47714-8018
Phone (812) 477-7246
112 Keeton Dr
Hopkinsville, KY 42240-8756
Phone (270) 881-4150
Hospital & facility affiliations
- Jennie Stuart Medical Center
- Baptist Health Deaconess Madisonville
- Trigg County Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KY, IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20201230002277 | KY | Practitioner - Nurse Practitioner | 0042623597 | Reassigns benefits to 2 organizations |
| I20211018001747 | IN | Practitioner - Nurse Practitioner | 0042623597 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3014910 | KY | MD | Interventional Pain Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pain Management Centers of America, PSC | Interventional Pain Medicine | Current |
Accepting new patients |
| Jessica Anglin NP PLLC | Current | Accepting new patients | |
| Advanced Pain Care Clinic PSC | Interventional Pain Medicine | Current |
Accepting new patients |
| Advanced Pain Care Clinic | Interventional Pain Medicine | Past | Accepting new patients |
| Pain Management Centers of America, PSC | Interventional Pain Medicine | Past | Accepting new patients |
Locations
1101 Professional Blvd
Ste 104
Evansville, IN 47714
Phone (502) 523-1295
1101 Professional Blvd
Ste 100
Evansville, IN 47714
Phone (812) 573-1207
112 Keeton Dr
Hopkinsville, KY 42240
Phone (270) 554-8373
200 Clinic Dr
Fl 6
Madisonville, KY 42431
Phone (270) 554-8373
200 Clinic Dr
Fl 3
Madisonville, KY 42431
Phone (270) 825-7214
1195 S Main St
#D
Madisonville, KY 42431
Phone (812) 505-2164
3332 Villa Pt
Ste 104
Owensboro, KY 42303
Phone (270) 594-4892
67 Lakeview Dr
Paducah, KY 42001
Phone (270) 554-8373
6426 Highway 51 N
Ste B
Horn Lake, MS 38637
Phone (662) 440-7246
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Pain Medicine Physician | 208VP0014X | 3014910 | KY | |
| Family Nurse Practitioner | 363LF0000X | 3014910 | KY | Yes |
Addresses
Primary practice location
200 Clinic Dr FL 6
Madisonville, KY 42431-1661
Mailing address
1101 Professional Blvd Ste 100
Evansville, IN 47714-8018
Phone (812) 477-7246
Other practice location 1
112 Keeton Dr
Hopkinsville, KY 42240-8756
Phone (270) 881-4150
Other practice location 2
1101 Professional Blvd Ste 100
Evansville, IN 47714-8018
Phone (812) 477-7246
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 710053770 | Medicaid | KY |
Other providers in Madisonville, KY
- Elizabeth A. Almes
- Sarah Almon
- Americas Number One Health Store Inc
- Craig B. Amundson
- Katherine Andrews
- Hari Krishna Ankem
- Humza A Ansari
- Katie Oakley Anthony
- Perry Jonathan Arnett
- Stephanie Gail Arnold
All providers in Madisonville, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.