Individual provider Active NPI

Kaitlin Medlin Bauer, APRN

  • Family Nurse Practitioner
  • New Albany, IN
National Provider Identifier
1366041857
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3015029 Issued in KY
Practice address
2305 Green Valley Rd
New Albany, IN 47150-4691
Phone
(812) 949-0405
NPI assigned
Oct 26, 2020
Last updated
Jul 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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 3015029 KY Primary

Addresses

Primary practice location

2305 Green Valley Rd
New Albany, IN 47150-4691

Mailing address

2305 Green Valley Rd
New Albany, IN 47150-4691
Phone (812) 949-0405

Other names 1

  • Kaitlin Marie Medlin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20201028001811 KY Practitioner - Nurse Practitioner 8224448501 Reassigns benefits to 1 organization
I20201207000971 IN Practitioner - Nurse Practitioner 8224448501 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3015029KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kiosk Medicine Kentucky LLC Family CurrentSince Oct 22, 2020 Accepting new patients
Little Clinic of in LLC Family CurrentSince Dec 4, 2020 Accepting new patients
Nassim and Associates, PSC PastSince Jul 23, 2023 Accepting new patients

Locations

815 Highlander Point Dr
Floyds Knobs, IN 47119
Phone (812) 923-7146

1330 W Southport Rd
Indianapolis, IN 46217
Phone (317) 215-2355

5350 E Thompson Rd
Indianapolis, IN 46237
Phone (317) 396-0814

3039 Breckenridge Ln
Louisville, KY 40220
Phone (502) 451-4555

9080 Taylorsville Rd
Louisville, KY 40299
Phone (502) 491-8805

Interoperability endpoints

  • Direct secure messaging: kaitlin.medlin@krogerhealth.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1366041857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 GREEN VALLEY RD",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504691",
            "telephone_number": "812-949-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 GREEN VALLEY RD",
            "city": "NEW ALBANY",
            "state": "IN",
            "postal_code": "471504691",
            "telephone_number": "812-949-0405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "KAITLIN",
        "middle_name": "MEDLIN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3015029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "MEDLIN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Albany, IN

Sources for this page

Verify at the official NPI Registry.