Individual provider Active NPI

Jason W Dunn, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Elizabethtown, KY
National Provider Identifier
1356895916
Registry record updated Aug 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3010523 Issued in KY
Practice address
2608 Ring Rd Ste B107
Elizabethtown, KY 42701
Phone
(270) 506-3741
Fax
(270) 506-3768
NPI assigned
Aug 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3010523 KY Primary

Addresses

Primary practice location

2608 Ring Rd Ste B107
Elizabethtown, KY 42701

Mailing address

PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 858-6655

Other practice location 1

2608 Ring Rd Ste B107
Elizabethtown, KY 42701
Phone (270) 506-3741

Other identifiers 2

IdentifierTypeStateIssuer
7100417730MedicaidKY
13875035OtherCAQH

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
I20161005001609 KY Practitioner - Nurse Practitioner 1355639477 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

360 Keen St
Burkesville, KY 42717-7915
Phone (270) 864-2889

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3010523KYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cumberland Family Medical Center Inc CurrentSince Dec 30, 2021 Accepting new patients
Cumberland Family Medical Center Inc CurrentSince Dec 30, 2021 Accepting new patients

Locations

360 Keen St
Burkesville, KY 42717
Phone (270) 864-1472

1323 Saint John Rd
Elizabethtown, KY 42701
Phone (270) 769-5983

2300 Nelson Dr
Elizabethtown, KY 42701
Phone (270) 769-8930

110 W A Jenkins Rd
Elizabethtown, KY 42701
Phone (270) 737-6612

384 W A Jenkins Rd
Elizabethtown, KY 42701
Phone (270) 769-8906

2608 Ring Rd
Ste B107
Elizabethtown, KY 42701
Phone (270) 506-3741

170 W A Jenkins Rd
Elizabethtown, KY 42701
Phone (270) 765-2658

521 Charlemagne Blvd
#360
Elizabethtown, KY 42701

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": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1356895916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1080",
            "city": "BURKESVILLE",
            "state": "KY",
            "postal_code": "427171080",
            "telephone_number": "270-858-6655",
            "fax_number": "270-858-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 RING RD STE B107",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "42701",
            "telephone_number": "270-506-3741",
            "fax_number": "270-506-3768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2608 Ring Rd Ste B107",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "KY",
            "postal_code": "42701",
            "country_code": "US",
            "telephone_number": "270-506-3741",
            "fax_number": "270-506-3768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNN",
        "first_name": "JASON",
        "middle_name": "W",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-11",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3010523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100417730",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "13875035",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.