Individual provider Active NPI

Jessica N. Daffron, APRN

  • Nurse Practitioner
  • Bowling Green, KY
National Provider Identifier
1255955654
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3014831 Issued in KY
Practice address
6807 Louisville Rd
Bowling Green, KY 42101-8015
Phone
(270) 781-6477
Fax
(270) 781-6479
NPI assigned
Jun 1, 2020
Last updated
Jun 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 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 57196 KY
Nurse Practitioner 363L00000X 3014831 KY Primary

Addresses

Primary practice location

6807 Louisville Rd
Bowling Green, KY 42101-8015

Mailing address

201 Park St
Bowling Green, KY 42101-1708
Phone (270) 781-5111

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
I20200831002442 KY Practitioner - Nurse Practitioner 0244657633 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

6807 Louisville Rd
Bowling Green, KY 42101-8015
Phone (270) 781-6477

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57196KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Graves Gilbert Clinic PLLC CurrentSince Aug 1, 2021 Accepting new patients
Graves Gilbert Clinic PLLC Nurse Practitioner CurrentSince Aug 1, 2021 Accepting new patients
Southern Kentucky Nephrology Associates PSC CurrentSince Sep 1, 2020 Accepting new patients
Jay Tomes Davis, MD, Obstetrics & Gynecology PSC PastSince Sep 1, 2020 Accepting new patients
Southern Ky Nephrology Nurse Practitioner PastSince Jun 1, 2020 Accepting new patients

Locations

1225 Fairway St
Bowling Green, KY 42103
Phone (270) 781-3910

1325 Andrea St
Ste 200
Bowling Green, KY 42104
Phone (270) 781-1772

201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229

2724 Nashville Rd
Bowling Green, KY 42101
Phone (270) 780-0560

5575 Scottsville Rd
Bowling Green, KY 42104
Phone (270) 282-7088

5796 Nashville Rd
Bowling Green, KY 42101
Phone (270) 745-0987

6807 Louisville Rd
Bowling Green, KY 42101
Phone (270) 597-3757

720 2nd Ave
Ste 203
Bowling Green, KY 42101
Phone (270) 843-5114

720 2nd Ave
Ste 301
Bowling Green, KY 42101
Phone (270) 843-5114

825 2nd Ave
Ste C2
Bowling Green, KY 42101
Phone (270) 780-2750

1112 S Main St
Franklin, KY 42134
Phone (270) 586-1969

405 S L Rogers Wells Blvd
Glasgow, KY 42141
Phone (270) 479-0260

Interoperability endpoints

  • Direct secure messaging: jessicadaffron@ggc.allscriptsdirect.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1255955654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011708",
            "telephone_number": "270-781-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6807 LOUISVILLE RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421018015",
            "telephone_number": "270-781-6477",
            "fax_number": "270-781-6479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAFFRON",
        "first_name": "JESSICA",
        "middle_name": "N.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-01",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "57196",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3014831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.