Individual provider Active NPI

Kristen Vanderboegh Carter

  • Nurse Practitioner
  • Crestview Hills, KY
National Provider Identifier
1154885549
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3012927 Issued in KY
Practice address
651 Centre View Blvd
Crestview Hills, KY 41017-5419
Phone
(859) 757-2927
Fax
(859) 341-0203
NPI assigned
Jan 30, 2019
Last updated
Jun 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3012927 KY Primary

Addresses

Primary practice location

651 Centre View Blvd
Crestview Hills, KY 41017-5419

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 344-5555

Other identifiers 1

IdentifierTypeStateIssuer
3012927MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kcarter95002@bhkydirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190319002674 KY Practitioner - Nurse Practitioner 6608116165 Reassigns benefits to 1 organization
I20190508001511 IL Practitioner - Nurse Practitioner 6608116165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Kentucky College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

651 Centre View Boulvard
Crestview Hills, KY 41017-5419
Phone (859) 331-6466

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3012927KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Jul 14, 2025 Accepting new patients
Summit Medical Group, Inc Nurse Practitioner CurrentSince Jul 14, 2025 Accepting new patients
Baptist Health Medical Group Inc Nurse Practitioner CurrentSince Jan 20, 2020 Accepting new patients

Locations

28 Chick St
Metropolis, IL 62960
Phone (618) 427-2680

651 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 341-6660

4900 Houston Rd
Florence, KY 41042
Phone (859) 212-5200

7370 Turfway Rd
Florence, KY 41042
Phone (859) 212-5125

1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070

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

4620 Village Square Dr
Paducah, KY 42001
Phone (270) 442-8575

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: kcarter95002@bhkydirect.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1154885549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-344-5555",
            "fax_number": "859-344-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 CENTRE VIEW BLVD",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410175419",
            "telephone_number": "859-757-2927",
            "fax_number": "859-341-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "KRISTEN",
        "middle_name": "VANDERBOEGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-30",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3012927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3012927",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcarter95002@bhkydirect.com",
            "affiliation": "N",
            "address_1": "4620 Village Square Dr",
            "city": "Paducah",
            "state": "KY",
            "country_code": "US",
            "postal_code": "420017501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crestview Hills, KY

Sources for this page

Verify at the official NPI Registry.