Melody Brewer, APRN
Individual provider Active NPI Family Nurse Practitioner · Booneville, KY
NPI 1326511601 · NPPES record last updated Mar 13, 2019
Key facts
- NPI
- 1326511601
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 3012983 (KY)
- Practice address
- 104 Main St
Booneville, KY 41339 - Phone
- (606) 593-6400
- NPI assigned
- Jan 9, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- County Line Primary Care
Practice addresses (Care Compare)
1550 Hwy 15 S
Suite 240
Jackson, KY 41339-0709
Phone (606) 824-5037
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200512003311 | KY | Practitioner - Nurse Practitioner | 6608207352 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3012983 | KY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County Line Primary Care | Current |
Accepting new patients |
Locations
9221 Ky 15 S
Campton, KY 41301
Phone (606) 568-1184
1550 Highway 15 S
Ste 240
Jackson, KY 41339
Phone (606) 272-7533
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3012983 | KY | Yes |
Addresses
Primary practice location
104 Main St
Booneville, KY 41339
Mailing address
104 Main St
Booneville, KY 41314
Other providers in Booneville, KY
- Jessica Anderson
- Angel Renee Birch
- Brittany Bobrowski
- Booneville Family Dentistry
- Kevin Brashear
- Kristina Michelle Byrd
- Roger Darrell Campbell
- Matthew Carrico
- Tammy Sue Caudell
- Amber Chaney
All providers in Booneville, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.