Individual provider Active NPI

Jennifer P McKinley, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1336492214
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3007713 Issued in KY
Practice address
2949 Breckenridge LN
Louisville, KY 40220-1408
Phone
(502) 446-5555
Fax
(502) 394-3670
NPI assigned
Oct 17, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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 3007713 KY Primary

Addresses

Primary practice location

2949 Breckenridge LN
Louisville, KY 40220-1408

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other identifiers 2

IdentifierTypeStateIssuer
7100226370MedicaidKY
12453444OtherCAQH

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
I20121114000295 KY Practitioner - Nurse Practitioner 0244481521 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3007713KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince Feb 1, 2019 Accepting new patients
Community Medical Associates, Inc. Family Current Accepting new patients
Community Medical Associates, Inc. Family CurrentSince Feb 1, 2019 Accepting new patients

Locations

2360 Stony Brook Dr
Louisville, KY 40220
Phone (502) 446-5462

1 Audubon Plaza Dr
Louisville, KY 40217
Phone (502) 634-6767

2949 Breckenridge Ln
Louisville, KY 40220
Phone (502) 446-5555

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

12101 Shelbyville Rd
Middletown, KY 40243
Phone (502) 244-7037

Interoperability endpoints

  • Direct secure messaging: jmckinley10887@direct.nortonhealthcare.org

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1336492214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2949 BRECKENRIDGE LN",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201408",
            "telephone_number": "502-446-5555",
            "fax_number": "502-394-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKINLEY",
        "first_name": "JENNIFER",
        "middle_name": "P",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-17",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3007713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100226370",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12453444",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.