Individual provider Active NPI

Brittany Ross

  • Nurse Practitioner
  • Utica, KY
National Provider Identifier
1265077101
Registry record updated Mar 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3013857 Issued in KY
Practice address
930 State Route 140 E
Utica, KY 42376-9003
Phone
(270) 302-8631
NPI assigned
Nov 14, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 3013857 KY
Nurse Practitioner 363L00000X 3013857 KY Primary

Addresses

Primary practice location

930 State Route 140 E
Utica, KY 42376-9003

Mailing address

930 State Route 140 E
Utica, KY 42376-9003
Phone (270) 302-8631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200325003179 KY Practitioner - Nurse Practitioner 2567890544 Reassigns benefits to 1 organization
I20200416003277 IN Practitioner - Nurse Practitioner 2567890544 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3013857KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Deaconess Clinic Inc Nurse Practitioner CurrentSince Mar 9, 2020 Accepting new patients
Deaconess Clinic, Inc Nurse Practitioner CurrentSince Mar 9, 2020 Accepting new patients
Deaconess Clinic Inc. Nurse Practitioner Current Accepting new patients
Deaconess Clinic, Inc Nurse Practitioner CurrentSince Apr 7, 2020 Accepting new patients
Deaconess Clinic, Inc Nurse Practitioner Past Accepting new patients

Locations

421 Chestnut St
Evansville, IN 47713
Phone (812) 426-6645

545 S Boehne Camp Rd
Evansville, IN 47712
Phone (812) 402-1264

1204 Williams St
Oakland City, IN 47660
Phone (812) 749-6187

2242 US Highway 41 N
Ste 2
Henderson, KY 42420

2242 US Highway 41 N
Henderson, KY 42420
Phone (270) 844-8515

1700 US Highway 60 W
Morganfield, KY 42437
Phone (270) 389-0031

2710 Heartland Crossing Blvd
Owensboro, KY 42303
Phone (270) 561-0140

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1265077101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 STATE ROUTE 140 E",
            "city": "UTICA",
            "state": "KY",
            "postal_code": "423769003",
            "telephone_number": "270-302-8631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 STATE ROUTE 140 E",
            "city": "UTICA",
            "state": "KY",
            "postal_code": "423769003",
            "telephone_number": "270-302-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSS",
        "first_name": "BRITTANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "KY",
            "license": "3013857",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3013857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, KY

Sources for this page

Verify at the official NPI Registry.