Individual provider Active NPI

Jane Anne Smith, APRN

  • Pediatric Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1205855194
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
3004394 Issued in KY
Practice address
2400 Greatstone PT
Lexington, KY 40504
Phone
(859) 323-2181
Fax
(859) 257-7706
NPI assigned
Jul 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 3004394 KY Primary

Addresses

Primary practice location

2400 Greatstone PT
Lexington, KY 40504

Mailing address

2333 Alumni Park Plaza
Suite 200
Lexington, KY 40517-4012
Phone (859) 218-5677

Other identifiers 1

IdentifierTypeStateIssuer
78012820MedicaidKY

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
I20050124000762 KY Practitioner - Nurse Practitioner 0840240230 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3004394KYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Dec 10, 2004 Accepting new patients
University of Kentucky Past Accepting new patients

Locations

464 Linden Ave
Harrodsburg, KY 40330
Phone (859) 734-5441

2333 Alumni Park Plz
Ste 200
Lexington, KY 40517

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

2400 Greatstone Pt
Fl 2
Lexington, KY 40504

2400 Greatstone Pt
Lexington, KY 40504
Phone (859) 257-9800

740 S Limestone
Lexington, KY 40536
Phone (859) 257-3533

Interoperability endpoints

  • Direct secure messaging: jsmith21578@ukhcdirect.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1205855194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 ALUMNI PARK PLAZA",
            "address_2": "SUITE 200",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405174012",
            "telephone_number": "859-218-5677",
            "fax_number": "859-257-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 GREATSTONE PT",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40504",
            "telephone_number": "859-323-2181",
            "fax_number": "859-257-7706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JANE",
        "middle_name": "ANNE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KY",
            "license": "3004394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78012820",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.