Individual provider Active NPI

Jeremy Michael Payne, APRN

  • Family Nurse Practitioner
  • Owensboro, KY
National Provider Identifier
1366058422
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3013528 Issued in KY
Practice address
3110 Fairview Dr
Owensboro, KY 42303-2175
Phone
(270) 314-0733
Fax
(270) 240-1227
NPI assigned
Sep 23, 2020
Last updated
Mar 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 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 3013528 KY Primary

Addresses

Primary practice location

3110 Fairview Dr
Owensboro, KY 42303-2175

Mailing address

3110 Fairview Dr
Owensboro, KY 42303-2175
Phone (270) 314-0733

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
I20210203000478 KY Practitioner - Nurse Practitioner 3375957350 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centennial Heart LLCGroup PAC ID 9931204237, 121 clinicians

Practice addresses (Care Compare)

3110 Fairview Dr
Owensboro, KY 42303-2175
Phone (270) 240-2129

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.54 of 100Reported as group
Quality
74.82
Promoting interoperability
76
Improvement activities
40
Cost
86.96

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Roshan K Mathew, MD. P.S.C. CurrentSince Jan 1, 2021 Accepting new patients
Centennial Heart LLC Family CurrentSince Apr 1, 2025 Accepting new patients

Locations

1325 Andrea St
Ste 100
Bowling Green, KY 42104
Phone (270) 901-3454

125 Memorial Dr
Franklin, KY 42134
Phone (270) 586-6004

3110 Fairview Dr
Owensboro, KY 42303
Phone (270) 240-2129

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: jeremy.payne.p1@direct.aco.nextgenshare.com
  • Direct secure messaging: jeremy.payne@hca1.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1366058422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 FAIRVIEW DR",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423032175",
            "telephone_number": "270-314-0733",
            "fax_number": "270-240-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3110 FAIRVIEW DR",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423032175",
            "telephone_number": "270-314-0733",
            "fax_number": "270-240-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "JEREMY",
        "middle_name": "MICHAEL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-23",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.