Individual provider Active NPI

Kari Villarreal, N.P.

  • Nurse Practitioner
  • Crestview Hills, KY
National Provider Identifier
1104823905
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3008426 Issued in KY
Practice address
350 Thomas More Pkwy
Suite 280
Crestview Hills, KY 41017-5465
Phone
(859) 426-0800
Fax
(859) 426-4140
NPI assigned
Jul 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 71001762A IN
Nurse Practitioner 363L00000X 3008426 KY Primary

Addresses

Primary practice location

350 Thomas More Pkwy
Suite 280
Crestview Hills, KY 41017-5465

Mailing address

350 Thomas More Pkwy
Suite 280
Crestview Hills, KY 41017-5465
Phone (859) 426-0800

Other identifiers 5

IdentifierTypeStateIssuer
000000380313OtherINANTHEM
78016268MedicaidKY
0098779MedicaidOH
200190950AMedicaidIN
306607332001MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71001762AINMDNurse Practitioner
3008426KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-State Orthopaedic Surgeons, Inc. Nurse Practitioner Past Accepting new patients
Ohio Valley Heartcare Inc Past Accepting new patients

Organizations & group practices 2

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1104823905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 THOMAS MORE PKWY",
            "address_2": "SUITE 280",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410175465",
            "telephone_number": "859-426-0800",
            "fax_number": "859-426-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 THOMAS MORE PKWY",
            "address_2": "SUITE 280",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410175465",
            "telephone_number": "859-426-0800",
            "fax_number": "859-426-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLARREAL",
        "first_name": "KARI",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001762A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3008426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000380313",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78016268",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0098779",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200190950A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "306607332001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestview Hills, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.