Beverly Annett Jones, NURSE PRACTITIONER
Individual provider Active NPI Family Nurse Practitioner · Fredonia, KY
NPI 1194716167 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1194716167
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 1776P (KY)
- Practice address
- 700 Cassidy Ave
Fredonia, KY 42411-9207 - Phone
- (270) 545-3386
- Fax
- (270) 545-3712
- NPI assigned
- Oct 31, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Crittenden Community Hospital LLC
Practice addresses (Care Compare)
520 W Gum St
Marion, KY 42064-1516
Phone (270) 965-1042
Hospital & facility affiliations
- Caldwell County Home Health
- Crittenden Community Hospital
- Caldwell Medical Center
- Baptist Health Paducah
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040908000407 | KY | Practitioner - Nurse Practitioner | 9830165166 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1776P | KY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crittenden County Hospital | Current | Accepting new patients | |
| Crittenden Community Hospital LLC | Current |
Accepting new patients | |
| Purchase District Health Dept | Current | Accepting new patients | |
| Purchase District Health Dept | Current |
Accepting new patients | |
| Family Practice Clinic PSC | Family | Current | Accepting new patients |
| Crittenden Community Hospital LLC | Current |
Accepting new patients | |
| Purchase District Health Dept | Current |
Accepting new patients | |
| Family Practice Care LLC | Family | Past | Accepting new patients |
| Crittenden Community Hospital LLC | Past | Accepting new patients | |
| Crittenden Community Hospital LLC | Past | Accepting new patients | |
| Purchase District Health Department | Past | Accepting new patients |
Locations
370 S Washington St
Clinton, KY 42031
Phone (270) 653-6110
700 Cassidy Ave
Fredonia, KY 42411
Phone (270) 545-3386
21234 Marion Rd
Fredonia, KY 42411
Phone (270) 545-2929
350 Browder St
Fulton, KY 42041
Phone (270) 472-1982
402 Troy Ave
Hickman, KY 42050
Phone (270) 236-2825
518 W Gum St
Marion, KY 42064
Phone (270) 965-5238
916 Kentucky Ave
Paducah, KY 42003
Phone (270) 444-9625
Interoperability endpoints
- https://fhir-usa.unify.chbase.com/org/critten-2b2d21fb
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 1776P | KY | |
| Family Nurse Practitioner | 363LF0000X | 1776P | KY | Yes |
Addresses
Primary practice location
700 Cassidy Ave
Fredonia, KY 42411-9207
Mailing address
PO Box 195
700 Cassidy Avenue
Fredonia, KY 42411-0195
Phone (270) 545-3386
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78009891 | Medicaid | KY |
Other providers in Fredonia, KY
- Easycare Inc
- Easycare Inc
- Family Practice Care LLC
- Family Practice Care LLC
- Scott R Graham
- Sunny Neal
- Janet Stewart
All providers in Fredonia, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.