Individual provider Active NPI

Roberta Lee Pool, ARNP

  • Nurse Practitioner
  • Corbin, KY
National Provider Identifier
1194704049
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4101P Issued in KY
Practice address
140 Bryan Blvd
Corbin, KY 40701-2775
Phone
(606) 523-2005
Fax
(606) 523-9704
NPI assigned
Jan 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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 4101P KY Primary

Addresses

Primary practice location

140 Bryan Blvd
Corbin, KY 40701-2775

Mailing address

140 Bryan Blvd
Corbin, KY 40701-2775
Phone (606) 523-2005

Other identifiers 2

IdentifierTypeStateIssuer
000000601701OtherKYANTHEM
78010717MedicaidKY

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
I20040809001037 KY Practitioner - Nurse Practitioner 1850363078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
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)

45 Moonbow PLZ
Corbin, KY 40701-8949
Phone (606) 523-9010

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
4101PKYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Nurse Practitioner Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince May 1, 2022 Accepting new patients
Baptist Health Medical Group Inc Nurse Practitioner CurrentSince May 1, 2022 Accepting new patients

Locations

602 Knox St
Barbourville, KY 40906
Phone (606) 546-6027

45 Moonbow Plz
Corbin, KY 40701
Phone (606) 523-9010

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

140 Bryan Blvd
Corbin, KY 40701
Phone (606) 523-2005

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

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1194704049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BRYAN BLVD",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012775",
            "telephone_number": "606-523-2005",
            "fax_number": "606-523-9704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BRYAN BLVD",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407012775",
            "telephone_number": "606-523-2005",
            "fax_number": "606-523-9704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOL",
        "first_name": "ROBERTA",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-10",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4101P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000601701",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78010717",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corbin, KY

Sources for this page

Verify at the official NPI Registry.