Jacob Dudley Coffey, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3011991 Issued in KY

Practice address

1 S Creek Dr Ste 102606
Monticello, KY 42633

Phone

(606) 348-3365

Fax

(606) 343-0067

NPI assigned

Jan 10, 2018

Last updated

Dec 11, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Lincoln Memorial University Medical Department, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Monticello Medical Associates, Inc.Group PAC ID 2062409154, 11 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lifeline Health Care of Pulaski Home health agency, Somerset, KY, CCN 187099
• Wayne County Hospital Hospital, Monticello, KY, CCN 181321
• Lake Cumberland Regional Hospital Hospital, Somerset, KY, CCN 180132

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacobcoffey@mmaky.allscriptsdirect.net

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.

• Monticello Medical Associates, Inc

  dba Monticello Medical Associates

  • Federally Qualified Health Center (FQHC)
  • Monticello, KY
  • NPI 1063007672
  Medicare reassignment Care Compare group
• Lake Cumberland Physician Practices, LLC

  dba Lake Cumberland Orthopedics

  • Orthopaedic Surgery Physician
  • Somerset, KY
  • NPI 1811356892

  Nurse Practitioner

  Medicare reassignment NPD
• Lake Cumberland Physician Practices LLC

  dba Gastroenterology of Lake Cumberland

  • Gastroenterology Physician
  • Somerset, KY
  • NPI 1174091383

  Nurse Practitioner

  NPD
• Lake Cumberland Physician Practices LLC

  • Internal Medicine Physician
  • Somerset, KY
  • NPI 1689115172

  Nurse Practitioner

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lake Cumberland Regional Hospital LLC

  dba Lake Cumberland Regional Hospital

  • Rural Acute Care Hospital
  • Somerset, KY
  • NPI 1619038247
  Care Compare affiliation
• Lifeline Home Health Care of Somerset, LLC

  dba Lifeline Health Care of Pulaski

  • Home Health Agency
  • Somerset, KY
  • NPI 1114951993
  Care Compare affiliation
• Wayne County Hospital, Inc

  • Critical Access Hospital
  • Monticello, KY
  • NPI 1871548016
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1194232207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S CREEK DR STE 102",
            "city": "MONTICELLO",
            "state": "KY",
            "postal_code": "426339472",
            "telephone_number": "606-348-3365",
            "fax_number": "606-343-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S CREEK DR STE 102606",
            "city": "MONTICELLO",
            "state": "KY",
            "postal_code": "42633",
            "telephone_number": "606-348-3365",
            "fax_number": "606-343-0067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Hail Knob Rd",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "KY",
            "postal_code": "425033434",
            "country_code": "US",
            "telephone_number": "606-678-9617",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 Langdon St",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "KY",
            "postal_code": "425032750",
            "country_code": "US",
            "telephone_number": "606-679-7441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COFFEY",
        "first_name": "JACOB",
        "middle_name": "DUDLEY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-10",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3011991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Chadwick
• Bryce A Childers, PHARMD
• Danielle Choate, APRN
• Amy Elizabeth Clark, SLP
• Ashton R Coffey, PHARM D
• Commonwealth Case Management, LLC
• Community Care Pharmacy, L.L.C. (Community Care Pharmacy)
• Jennifer Brown Compton, O.D.
• Ginger Conn
• Joseph A Correll, LPCC

• Nurse Practitioner in Monticello, KY
• Providers in Monticello, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.