Individual provider Active NPI

Lea Anne Bunch, APRN

  • Family Nurse Practitioner
  • Elizabethtown, KY
National Provider Identifier
1114535911
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3014772 Issued in KY
Practice address
1324 Woodland Dr Ste a
Elizabethtown, KY 42701-2662
Phone
(270) 765-5921
Fax
(270) 982-3324
NPI assigned
Jul 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3014772 KY Primary

Addresses

Primary practice location

1324 Woodland Dr Ste a
Elizabethtown, KY 42701-2662

Mailing address

761 Brackett Cemetery Rd
Upton, KY 42784-9210
Phone (270) 735-2574

Other practice location 1

12080 S Dixie Hwy
Sonora, KY 42776-9739
Phone (270) 975-4050

Other identifiers 1

IdentifierTypeStateIssuer
7100685330MedicaidKY

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200923000182 KY Practitioner - Nurse Practitioner 4385063478 Reassigns benefits to 1 organization

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
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1324 Woodland Dr
Suite a
Elizabethtown, KY 42701-2651
Phone (270) 765-5921

Hospital & facility affiliations

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
3014772KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Jul 1, 2022 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Jul 1, 2022 Accepting new patients
Baptist Health Medical Group Inc Family Medicine Current Accepting new patients

Locations

1324 Woodland Dr
Ste A
Elizabethtown, KY 42701

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1594944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1114535911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 BRACKETT CEMETERY RD",
            "city": "UPTON",
            "state": "KY",
            "postal_code": "427849210",
            "telephone_number": "270-735-2574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 WOODLAND DR STE A",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012662",
            "telephone_number": "270-765-5921",
            "fax_number": "270-982-3324"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12080 S Dixie Hwy",
            "address_purpose": "LOCATION",
            "city": "Sonora",
            "state": "KY",
            "postal_code": "427769739",
            "country_code": "US",
            "telephone_number": "270-975-4050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUNCH",
        "first_name": "LEA",
        "middle_name": "ANNE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-17",
        "last_updated": "2022-08-12",
        "certification_date": "2020-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3014772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100685330",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.