Kimberly Rose McKenna, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4091P Issued in KY

Practice address

106 Winston Way
Campbellsville, KY 42718-4953

Phone

(270) 789-0034

Fax

(270) 789-0097

NPI assigned

Oct 25, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

One Cross Health Clinic IncGroup PAC ID 2466790472, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Taylor Regional Hospital Hospital, Campbellsville, KY, CCN 180087

Merit-based Incentive Payment System (MIPS)

Final score

92.9 of 100Reported as group

Quality

85.93

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• One Cross Community, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lebanon, KY
  • NPI 1215404082

  5% Or Greater Direct Ownership Interest, Operational/Managerial Control

  CMS ownership
• One Cross Community, Inc.

  • Federally Qualified Health Center (FQHC)
  • Campbellsville, KY
  • NPI 1447710314

  Operational/Managerial Control, W-2 Managing Employee

  CMS ownership
• One Cross Health Clinic Inc

  • Rural Health Clinic/Center
  • Campbellsville, KY
  • NPI 1942606454

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

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.

• One Cross Health Clinic Inc

  • Rural Health Clinic/Center
  • Campbellsville, KY
  • NPI 1942606454
  Medicare reassignment Care Compare group NPD Authorized official
• One Cross Community, Inc.

  • Federally Qualified Health Center (FQHC)
  • Campbellsville, KY
  • NPI 1447710314
  Medicare reassignment Authorized official
• One Cross Health Clinic, Inc.

  • Rural Health Clinic/Center
  • Lebanon, KY
  • NPI 1538636311
  NPD (past) Authorized official
• Genesis Enterprises, Inc.

  • Family Medicine Physician
  • Columbia, KY
  • NPI 1730243858
  NPD (past)

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

• Taylor County Hospital District Health Facilities Corporation

  • General Acute Care Hospital
  • Campbellsville, KY
  • NPI 1689761942
  Care Compare affiliation

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676419200000",
    "number": "1295810786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 WINSTON WAY STE 5",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427184991",
            "telephone_number": "270-789-0034",
            "fax_number": "270-789-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 WINSTON WAY",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427184953",
            "telephone_number": "270-789-0034",
            "fax_number": "270-789-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "KIMBERLY",
        "middle_name": "ROSE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4091P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78012481",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Lauren Mattingly, APRN
• Sean E Maynard, PA-C
• McCloud Inc.
• Becky Jo McFee, PT
• Jessika McGuffin
• Richard Alexander McKinley
• McQueary Family Medicine Inc
• Maci McQueary, APRN
• Tearah McVay
• Britanii P McWhorter, RDN

• Family Nurse Practitioner in Campbellsville, KY
• Providers in Campbellsville, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.