Jacklyn Elaine Spagnoletti

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3013711 Issued in KY

Practice address

Casey County Primary Care
187 Wolford Avenue
Liberty, KY 42539-3278

Phone

(606) 787-8348

Fax

(606) 787-0251

NPI assigned

Aug 13, 2019

Last updated

Mar 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Casey County Hospital DistrictGroup PAC ID 0749193423, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Casey County Hospital Hospital, Liberty, KY, CCN 181309

Merit-based Incentive Payment System (MIPS)

Final score

69.66 of 100Reported as group

Quality

39.23

Promoting interoperability

99

Improvement activities

40

Cost

43.79

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/caseyco-4151b385

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.

• Casey County Hospital District

  • Critical Access Hospital
  • Liberty, KY
  • NPI 1407829567
  Medicare reassignment Care Compare group NPD
• Casey County Hospital District

  dba Casey County Family Practice

  • Rural Health Clinic/Center
  • Liberty, KY
  • NPI 1679720114
  NPD
• Casey County Hospital District

  dba Casey County Primary Care

  • Rural Health Clinic/Center
  • Liberty, KY
  • NPI 1871567362
  NPD

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

• Casey County Hospital District

  • Critical Access Hospital
  • Liberty, KY
  • NPI 1407829567
  Care Compare affiliation

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

{
    "created_epoch": "1565654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1275189508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 WOLFORD AVE",
            "city": "LIBERTY",
            "state": "KY",
            "postal_code": "425393278",
            "telephone_number": "606-787-6275",
            "fax_number": "606-787-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CASEY COUNTY PRIMARY CARE",
            "address_2": "187 WOLFORD AVENUE",
            "city": "LIBERTY",
            "state": "KY",
            "postal_code": "425393278",
            "telephone_number": "606-787-8348",
            "fax_number": "606-787-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAGNOLETTI",
        "first_name": "JACKLYN",
        "middle_name": "ELAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-13",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3013711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hilary Ann Shuffett, P.A.
• Jennifer Shugars
• Stefanie Sidwell, DPT
• Michael S Sloane, PT
• Elissa Smith, OTR/L
• Brooke Sprowles, PHARM D.
• Phyllis Reynolds Spurlin, R,PH.
• Stanford Family Medicine & Obstetrics PSC
• Regina A Stevens
• Dawn Renee Stotts, P.T.A.

• Nurse Practitioner in Liberty, KY
• Providers in Liberty, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.