Active NPI
Mary Jessi Milby, FNP-C
- Family Nurse Practitioner
- Elizabethtown, KY
National Provider Identifier
1306733308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4042567
- Practice address
- 3040 Dolphin Dr
Elizabethtown, KY 42701-7125 - Phone
- (270) 370-1240
- NPI assigned
- Jun 23, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4042567 | KY | Primary |
Addresses
Primary practice location
3040 Dolphin Dr
Elizabethtown, KY 42701-7125
Mailing address
PO Box 932958
Cleveland, OH 44193-0028
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4042567 | Other | KY | APRN |
| 1167892 | Other | KY | RN |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3040 Dolphin Dr
Elizabethtown, KY 42701-7135
Phone (270) 370-1240
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kiosk Medicine Kentucky LLC | Family | Current | Accepting new patients |
Locations
102 W John Rowan Blvd
Bardstown, KY 40004
Phone (502) 348-3062
3040 Dolphin Dr
Elizabethtown, KY 42701
Phone (270) 370-1240
3039 Breckenridge Ln
Louisville, KY 40220
Phone (502) 451-4555
Interoperability endpoints
- mary.milby@krogerhealth.eclinicaldirectplus.com
Organizations & group practices 2
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.
-
- Family Nurse Practitioner
- Louisville, KY
- NPI 1205885035
-
- Family Medicine Physician
- Paducah, KY
- NPI 1922401611
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1750636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751068800000",
"number": "1306733308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 932958",
"city": "CLEVELAND",
"state": "OH",
"postal_code": "441930028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3040 DOLPHIN DR",
"city": "ELIZABETHTOWN",
"state": "KY",
"postal_code": "427017125",
"telephone_number": "270-370-1240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILBY",
"first_name": "MARY",
"middle_name": "JESSI",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-23",
"last_updated": "2025-06-28",
"certification_date": "2025-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": "4042567",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APRN",
"identifier": "4042567",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN",
"identifier": "1167892",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elizabethtown, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2025; 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.