NPIMap

Individual provider Active NPI

Kalyn Nicole Churchill, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1114658911
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3017857 Issued in KY
Practice address
12615 Taylorsville Rd Ste a
Louisville, KY 40299-4452
Phone
(502) 261-1595
Fax
(502) 261-1590
NPI assigned
Jun 22, 2022
Last updated
Jun 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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 3017857 KY Primary

Addresses

Primary practice location

12615 Taylorsville Rd Ste a
Louisville, KY 40299-4452

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 559-9407

Other identifiers 2

IdentifierTypeStateIssuer
300065508MedicaidIN
7100832580MedicaidKY

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
I20220801002685 KY Practitioner - Nurse Practitioner 6002298452 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3017857KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Jul 19, 2022 Accepting new patients
Community Medical Associates, Inc. Family Current Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Jul 19, 2022 Accepting new patients
University of Louisville Physicians, Inc. Current Accepting new patients
Community Medical Associates, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Community Medical Associates, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Community Medical Associates, Inc. Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

12615 Taylorsville Rd
Ste A
Louisville, KY 40299
Phone (502) 261-1595

1900 Bluegrass Ave
Ste 103
Louisville, KY 40215

3920 Dutchmans Ln
Louisville, KY 40207
Phone (502) 259-6000

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

850 S 28th St
Ste 102
Louisville, KY 40211
Phone (502) 629-5400

Interoperability endpoints

  • Direct secure messaging: kchurchill301042@direct.nortonhealthcare.org

Organizations & group practices 7

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1114658911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-559-9407",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12615 TAYLORSVILLE RD STE A",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402994452",
            "telephone_number": "502-261-1595",
            "fax_number": "502-261-1590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCHILL",
        "first_name": "KALYN",
        "middle_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-22",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3017857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300065508",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100832580",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.