NPIMap

Individual provider Active NPI

Jamie L Cannady, NP

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1205207131
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3016421 Issued in KY
Practice address
100 Mallard Creek Rd Ste 320
Louisville, KY 40207-5136
Phone
(502) 855-6125
Fax
(502) 394-1972
NPI assigned
Oct 19, 2015
Last updated
Dec 13, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 0024172927 VA
Family Nurse Practitioner 363LF0000X 3016421 KY Primary

Addresses

Primary practice location

100 Mallard Creek Rd Ste 320
Louisville, KY 40207-5136

Mailing address

100 Mallard Creek Rd Ste 320
Louisville, KY 40207-5136
Phone (502) 855-6125

Other identifiers 1

IdentifierTypeStateIssuer
C06778OtherVAGROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220126001219 KY Practitioner - Nurse Practitioner 9234439811 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

100 Mallard Creek Rd
Suite 320
Louisville, KY 40207-5136
Phone (502) 855-6125

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3016421KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Nurse Practitioner Current Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Dec 1, 2021 Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Dec 1, 2021 Accepting new patients
Bon Secours-St. Mary's Hospital of Richmond, Inc. Past Accepting new patients
Bon Secours-St. Mary's Hospital of Richmond, Inc. Past Accepting new patients
Bon Secours-St. Mary's Hospital of Richmond, Inc. Past Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner Past Accepting new patients
Bon Secours-St. Mary's Hospital of Richmond, Inc. Past Accepting new patients

Locations

7926 Preston Hwy
Ste 106
Louisville, KY 40219
Phone (502) 964-4357

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

100 Mallard Creek Rd
Ste 320
Saint Matthews, KY 40207
Phone (502) 690-8782

Interoperability endpoints

  • Direct secure messaging: jcannady221455@direct.nortonhealthcare.org

Organizations & group practices 8

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 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639353600000",
    "number": "1205207131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MALLARD CREEK RD STE 320",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402075136",
            "telephone_number": "502-855-6125",
            "fax_number": "502-394-1972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MALLARD CREEK RD STE 320",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402075136",
            "telephone_number": "502-855-6125",
            "fax_number": "502-394-1972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNADY",
        "first_name": "JAMIE",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-19",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024172927",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3016421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06778",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.