Individual provider Active NPI

Katharine Rose Cruse, APRN

  • Family Nurse Practitioner
  • Hodgenville, KY
National Provider Identifier
1124445473
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3008326 Issued in KY
Practice address
2101 Lincoln Farm Rd
Hodgenville, KY 42748-9704
Phone
(844) 435-0900
Fax
(270) 858-4029
NPI assigned
Mar 25, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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 3008326 KY Primary

Addresses

Primary practice location

2101 Lincoln Farm Rd
Hodgenville, KY 42748-9704

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 858-6655

Other identifiers 3

IdentifierTypeStateIssuer
12667985OtherCAQH
7100290900MedicaidKY
3008326OtherKYSTATE LICENSE

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
I20140430001718 KY Practitioner - Nurse Practitioner 3678706512 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Family Medical Center Inc CurrentSince Jun 19, 2017 Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Jun 19, 2017 Accepting new patients
Cumberland Family Medical Center Inc Past Accepting new patients

Locations

360 Keen St
Burkesville, KY 42717
Phone (270) 864-1472

197 Will Walker Rd
Columbia, KY 42728
Phone (270) 384-9981

33 Eagle Ln
Hodgenville, KY 42748
Phone (270) 358-3506

925 S Lincoln Blvd
Hodgenville, KY 42748
Phone (270) 358-2210

215 E Main St
Hodgenville, KY 42748
Phone (270) 358-0575

2101 Lincoln Farm Rd
Hodgenville, KY 42748
Phone (270) 358-4112

911 S Lincoln Blvd
Hodgenville, KY 42748

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.

NPI Registry JSON

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1124445473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6655",
            "fax_number": "270-858-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 LINCOLN FARM RD",
            "city": "HODGENVILLE",
            "state": "KY",
            "postal_code": "427489704",
            "telephone_number": "844-435-0900",
            "fax_number": "270-858-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUSE",
        "first_name": "KATHARINE",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-25",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3008326",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12667985",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100290900",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "3008326",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hodgenville, KY

Sources for this page

Verify at the official NPI Registry.