Individual provider Active NPI

Jodi Marie Mabry, APRN

  • Acute Care Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1306678016
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4026500 Issued in KY
Practice address
3900 Kresge Way
Louisville, KY 40207-4660
Phone
(502) 899-3858
NPI assigned
Aug 20, 2024
Last updated
Aug 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 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 4026500 KY Primary

Addresses

Primary practice location

3900 Kresge Way
Louisville, KY 40207-4660

Mailing address

801 Sandness CT
Louisville, KY 40243-1729
Phone (205) 405-6878

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
I20240919003314 KY Practitioner - Nurse Practitioner 7315488194 Reassigns benefits to 1 organization
I20241014003412 IN Practitioner - Nurse Practitioner 7315488194 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, shared by 31 NPIs, 2,431 clinicians

Practice addresses (Care Compare)

1919 State St
Suite 360
New Albany, IN 47150-6801
Phone (502) 928-0900

3900 Kresge Way
Suite 42
Louisville, KY 40207-4683
Phone (502) 894-9499

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4026500KYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Aug 21, 2024 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Oct 1, 2024 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Aug 21, 2024 Accepting new patients

Locations

1373 N State Road 62
Madison, IN 47250
Phone (812) 801-0196

1919 State St
Ste 360
New Albany, IN 47150
Phone (502) 928-0900

1901 Campus Pl
Louisville, KY 40299
Phone (502) 253-4911

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

3900 Kresge Way
Ste 42
Louisville, KY 40207
Phone (502) 894-9499

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1306678016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 SANDNESS CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431729",
            "telephone_number": "205-405-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 KRESGE WAY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074660",
            "telephone_number": "502-899-3858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABRY",
        "first_name": "JODI",
        "middle_name": "MARIE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-20",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "4026500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.