Individual provider Active NPI

Kristin Louise Mulloney, APRN

  • Acute Care Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1275383259
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4017363 Issued in KY
Practice address
1701 Nicholasville Rd
Lexington, KY 40503-1458
Phone
(859) 269-4668
NPI assigned
Mar 25, 2024
Last updated
Mar 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4017363 KY Primary

Addresses

Primary practice location

1701 Nicholasville Rd
Lexington, KY 40503-1458

Mailing address

114 Venice Park
Lexington, KY 40503-1841
Phone (859) 475-6168

Other practice location 1

4097 Nichols Park Dr
Lexington, KY 40503-4428
Phone (859) 245-2273

Other practice location 2

197 E Brannon Rd
Nicholasville, KY 40356-8060
Phone (859) 756-6849

Other identifiers 1

IdentifierTypeStateIssuer
4017363OtherKYKENTUCKYBOARDOFNURSING

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
I20241023003630 KY Practitioner - Nurse Practitioner 0345689162 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgetown Urgent Care PLLCGroup PAC ID 6608938287, 12 clinicians
Lexington Urgent Care PLLCGroup PAC ID 9830344688, 29 clinicians

Practice addresses (Care Compare)

111 Osbourne Way
Suite 101
Georgetown, KY 40324-8004
Phone (859) 466-8956

1701 Nicholasville Rd
Suite 100
Lexington, KY 40503-1461
Phone (859) 466-8956

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Man O War Urgent Care LLC CurrentSince Sep 10, 2024 Accepting new patients
Lexington Urgent Care PLLC CurrentSince Sep 10, 2024 Accepting new patients
Georgetown Urgent Care PLLC CurrentSince Sep 10, 2024 Accepting new patients
Berea Urgent Care LLC CurrentSince Sep 10, 2024 Accepting new patients
Onan Chiropractic PLLC PastSince Jul 10, 2016 Accepting new patients

Locations

234 Brenwood St
Berea, KY 40403
Phone (859) 985-0302

111 Osborne Way
#101
Georgetown, KY 40324
Phone (859) 466-8956

844 S College St
Harrodsburg, KY 40330
Phone (859) 605-6184

1701 Nicholasville Rd
Lexington, KY 40503
Phone (859) 278-9373

1701 Nicholasville Rd
Ste 100
Lexington, KY 40503
Phone (859) 466-8956

3101 Richmond Rd
Ste 202
Lexington, KY 40509
Phone (606) 266-2223

4097 Nichols Park Dr
Lexington, KY 40503
Phone (859) 245-2273

4097 Nichols Park Dr
Ste 108
Lexington, KY 40503
Phone (859) 245-2273

197 E Brannon Rd
Nicholasville, KY 40356
Phone (859) 523-5310

432 Lexington Rd
Versailles, KY 40383
Phone (859) 523-5310

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 6

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": "1711324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1275383259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 VENICE PARK",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031841",
            "telephone_number": "859-475-6168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 NICHOLASVILLE RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031458",
            "telephone_number": "859-269-4668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4097 Nichols Park Dr",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405034428",
            "country_code": "US",
            "telephone_number": "859-245-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "197 E Brannon Rd",
            "address_purpose": "LOCATION",
            "city": "Nicholasville",
            "state": "KY",
            "postal_code": "403568060",
            "country_code": "US",
            "telephone_number": "859-756-6849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLONEY",
        "first_name": "KRISTIN",
        "middle_name": "LOUISE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "4017363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKYBOARDOFNURSING",
            "identifier": "4017363",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.