Individual provider Active NPI

Kari June Blackburn, DNP, CPNP-PC

  • Pediatric Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1376961425
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
3008730 Issued in KY
Practice address
2400 Greatstone PT
Lexington, KY 40504-3274
Phone
(859) 257-1000
NPI assigned
Apr 4, 2014
Last updated
Sep 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 3008730 KY Primary
Pediatric Urology Physician 2088P0231X 3008730 KY

Addresses

Primary practice location

2400 Greatstone PT
Lexington, KY 40504-3274

Mailing address

4701 Spring Creek Dr
Lexington, KY 40515-1523
Phone (859) 979-1698

Other practice location 1

740 S Limestone
Lexington, KY 40536
Phone (859) 323-6469

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
I20151221001168 KY Practitioner - Nurse Practitioner 8820399694 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3008730KYMDPediatric Urology Physician

Interoperability endpoints

  • Direct secure messaging: kblackburn24218@ukhcdirect.org

Organizations & group practices 1

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": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1376961425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 SPRING CREEK DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405151523",
            "telephone_number": "859-979-1698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 GREATSTONE PT",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043274",
            "telephone_number": "859-257-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "740 S Limestone",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "40536",
            "country_code": "US",
            "telephone_number": "859-323-6469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKBURN",
        "first_name": "KARI",
        "middle_name": "JUNE",
        "name_prefix": "Dr.",
        "credential": "DNP, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-04",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "KY",
            "license": "3008730",
            "primary": true
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "",
            "desc": "Urology, Pediatric Urology",
            "state": "KY",
            "license": "3008730",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.