Individual provider Active NPI

Jessica Nicole King

  • Family Nurse Practitioner
  • Corydon, IN
National Provider Identifier
1124671490
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71009399A Issued in IN
Practice address
1141 Hospital Dr NW
Corydon, IN 47112-1774
Phone
(812) 738-4251
NPI assigned
Jul 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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 71009399A IN Primary

Addresses

Primary practice location

1141 Hospital Dr NW
Corydon, IN 47112-1774

Mailing address

1141 Hospital Dr NW
Corydon, IN 47112-1774

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
I20201001001332 KY Practitioner - Nurse Practitioner 9537490024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

411 E Chestnut St
5A
Louisville, KY 40202-1713
Phone (502) 588-7450

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71009399AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Children's Medical Group, LLC CurrentSince Oct 1, 2020 Accepting new patients
Norton Children's Medical Group, LLC Family CurrentSince Oct 1, 2020 Accepting new patients
Norton Children's Medical Group, LLC Current Accepting new patients
Norton Childrens Medical Group, LLC Family Past Accepting new patients

Locations

1858 Old Lebanon Rd
Campbellsville, KY 42718
Phone (270) 465-0632

1 Trillium Way
Ste 306
Corbin, KY 40701

411 E Chestnut St
#5A
Louisville, KY 40202
Phone (502) 588-2349

1 Audubon Plaza Dr
Louisville, KY 40217
Phone (502) 634-6767

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

200 Clinic Dr
Madisonville, KY 42431
Phone (270) 821-8874

Interoperability endpoints

  • Direct secure messaging: jking195009@direct.nortonhealthcare.org

Organizations & group practices 4

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": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1124671490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 HOSPITAL DR NW",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471121774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1141 HOSPITAL DR NW",
            "city": "CORYDON",
            "state": "IN",
            "postal_code": "471121774",
            "telephone_number": "812-738-4251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-16",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71009399A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corydon, IN

Sources for this page

Verify at the official NPI Registry.