Individual provider Active NPI

Makayla Jean Green, APRN, FNP-C

  • Nurse Practitioner
  • London, KY
National Provider Identifier
1154952844
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3014245 Issued in KY
Practice address
1649 Highway 192 W
London, KY 40741-1674
Phone
(606) 330-0055
NPI assigned
Jan 31, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3014245 KY
Nurse Practitioner 363L00000X 3014245 KY Primary

Addresses

Primary practice location

1649 Highway 192 W
London, KY 40741-1674

Mailing address

PO Box 735
Flat Lick, KY 40935-0735
Phone (606) 302-3525

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
I20200225002736 KY Practitioner - Nurse Practitioner 0244667582 Reassigns benefits to 3 organizations

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
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1 Trillium Way
Corbin, KY 40701-8420
Phone (606) 523-1934

Hospital & facility affiliations

  • Baptist Health Corbin Hospital, Corbin, KY, CCN 180080

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3014245KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Kentucky PLLC CurrentSince Jan 31, 2020 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Oct 6, 2022 Accepting new patients
Brock Medical, LLC Nurse Practitioner CurrentSince Jan 31, 2020 Accepting new patients
Southeastern Emergency Physicians LLC Nurse Practitioner CurrentSince Oct 28, 2023 Accepting new patients
Baptist Health Medical Group Inc Nurse Practitioner CurrentSince Oct 6, 2022 Accepting new patients
Pineville Community Health Center Inc Past Accepting new patients
Baptist Health Medical Group Inc Nurse Practitioner Past Accepting new patients

Locations

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

1649 Highway 192 W
London, KY 40741
Phone (606) 330-0055

850 Riverview Ave
Pineville, KY 40977
Phone (606) 337-3051

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 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": "1580428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706486400000",
    "number": "1154952844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735",
            "city": "FLAT LICK",
            "state": "KY",
            "postal_code": "409350735",
            "telephone_number": "606-302-3525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1649 HIGHWAY 192 W",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407411674",
            "telephone_number": "606-330-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MAKAYLA",
        "middle_name": "JEAN",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-31",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3014245",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3014245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in London, KY

Sources for this page

Verify at the official NPI Registry.