Individual provider Active NPI

Mary Jessi Milby, FNP-C

  • Family Nurse Practitioner
  • Elizabethtown, KY
National Provider Identifier
1306733308
Registry record updated Jun 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4042567 Issued in KY
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

Updated by the provider on Jun 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
4042567OtherKYAPRN
1167892OtherKYRN

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
I20250723001110 KY Practitioner - Nurse Practitioner 6002322369 Reassigns benefits to 2 organizations

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
Kiosk Medicine Kentucky LLCGroup PAC ID 6002887510, 169 clinicians

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

OrganizationSpecialtyStatusNew patients
Kiosk Medicine Kentucky LLC Family CurrentSince Jun 11, 2025 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.