Individual provider Active NPI

Dorothy Marie Dudley, APRN

  • Family Nurse Practitioner
  • Campbellsville, KY
National Provider Identifier
1144504689
Registry record updated Feb 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3007170 Issued in KY
Practice address
95 Kingswood Dr
Campbellsville, KY 42718-9604
Phone
(270) 789-2788
Fax
(502) 368-9820
NPI assigned
Oct 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2018

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 3007170 KY Primary

Addresses

Primary practice location

95 Kingswood Dr
Campbellsville, KY 42718-9604

Mailing address

1700 Old Lebanon Rd
Campbellsville, KY 42718-9615
Phone (270) 789-2788

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
I20111121000208 KY Practitioner - Nurse Practitioner 4587838925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Taylor Regional Medical Group LLCGroup PAC ID 4880616622, 60 clinicians

Practice addresses (Care Compare)

1700 Old Lebanon Rd
Campbellsville, KY 42718-9662
Phone (270) 789-6116

Hospital & facility affiliations

  • Taylor Regional Hospital Hospital, Campbellsville, KY, CCN 180087
  • Taylor Regional Hospital Nursing home, CCN 18U087

Merit-based Incentive Payment System (MIPS)

Final score
73.96 of 100Reported as group
Quality
62.41
Promoting interoperability
69
Improvement activities
40
Cost
71.3

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3007170KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Taylor Regional Medical Group,LLC Current Accepting new patients
Taylor Regjional Medical Group,LLC CurrentSince Oct 3, 2011 Accepting new patients
Taylor Regional Medical Group LLC Family CurrentSince Oct 3, 2011 Accepting new patients

Locations

1700 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-3561

95 Kingswood Dr
Campbellsvlle, KY 42718
Phone (270) 465-3812

1698 Old Lebanon Rd
Campbellsvlle, KY 42718
Phone (270) 465-3561

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 1

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": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518566400000",
    "number": "1144504689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 OLD LEBANON RD",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189615",
            "telephone_number": "270-789-2788",
            "fax_number": "502-368-9820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 KINGSWOOD DR",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189604",
            "telephone_number": "270-789-2788",
            "fax_number": "502-368-9820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "DOROTHY",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-03",
        "last_updated": "2018-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbellsville, KY

Sources for this page

Verify at the official NPI Registry.