Individual provider Active NPI

Katherine Bollinger, PA-C

  • Physician Assistant
  • Versailles, KY
National Provider Identifier
1164043352
Registry record updated Aug 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2964 Issued in KY
Practice address
117 Crossfield Dr Ste B
Versailles, KY 40383-1844
Phone
(859) 873-9188
Fax
(859) 873-0870
NPI assigned
Apr 29, 2020
Last updated
Aug 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2964 KY Primary

Addresses

Primary practice location

117 Crossfield Dr Ste B
Versailles, KY 40383-1844

Mailing address

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-6200

Other identifiers 1

IdentifierTypeStateIssuer
7100842050MedicaidKY

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
I20220921000924 KY Practitioner - Physician Assistant 8426442989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proactive Therapy, IncGroup PAC ID 0143245415, 118 clinicians
New Lexington Clinic PSCGroup PAC ID 3476457532, 329 clinicians

Practice addresses (Care Compare)

1004 Leawood Dr
Frankfort, KY 40601-3349
Phone (502) 223-7403

115 Crossfield Dr
Versailles, KY 40383-1845
Phone (859) 873-9843

1207 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-4000

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-4000

1225 S Broadway
Suite 201
Lexington, KY 40504-2701
Phone (859) 258-4568

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2964KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
New Lexington Clinic PSC CurrentSince Oct 17, 2022 Accepting new patients
New Lexington Clinic, PSC CurrentSince Oct 17, 2022 Accepting new patients

Locations

1221 S Broadway
Lexington, KY 40504
Phone (859) 258-4181

115 Crossfield Dr
Ste A
Versailles, KY 40383
Phone (859) 278-9413

117 Crossfield Dr
Ste B
Versailles, KY 40383
Phone (859) 258-4950

Interoperability endpoints

  • Direct secure messaging: katherine.bollinger.1@13059.direct.athenahealth.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 3

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": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786406400000",
    "number": "1164043352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-6200",
            "fax_number": "859-258-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 CROSSFIELD DR STE B",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403831844",
            "telephone_number": "859-873-9188",
            "fax_number": "859-873-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLINGER",
        "first_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2026-08-11",
        "certification_date": "2026-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100842050",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Versailles, KY

Sources for this page

Verify at the official NPI Registry.