Individual provider Active NPI

Stephanie Ann Byrne, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1386192300
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3010706 Issued in KY
Practice address
13802 Lake Point Cir Ste 102
Louisville, KY 40223-4219
Phone
(502) 245-4450
Fax
(502) 245-4462
NPI assigned
Sep 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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 3010706 KY Primary

Addresses

Primary practice location

13802 Lake Point Cir Ste 102
Louisville, KY 40223-4219

Mailing address

13802 Lake Point Cir Ste 102
Louisville, KY 40223-4219
Phone (502) 245-4450

Other practice location 1

2300 Hurstbourne Village Dr Ste 900
Louisville, KY 40299-1851
Phone (502) 245-4450

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
I20170307001946 KY Practitioner - Nurse Practitioner 3577847748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitalskin Medical Group Il PLLCGroup PAC ID 5991116261, 56 clinicians

Practice addresses (Care Compare)

13802 Lake Point Cir
Suite 102
Louisville, KY 40223-4219
Phone (217) 729-7868

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3010706KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vitalskin Medical Group Il PLLC CurrentSince Jul 28, 2022 Accepting new patients
Vitalskin Medical Group Il PLLC CurrentSince Jul 28, 2022 Accepting new patients

Locations

1111 W Kenyon Rd
Urbana, IL 61801
Phone (217) 729-7650

114 Manor Ave
Bardstown, KY 40004
Phone (217) 729-7868

2300 Hurstbourne Village Dr
Ste 900
Louisville, KY 40299
Phone (217) 729-7868

13802 Lake Point Cir
#102
Louisville, KY 40223
Phone (217) 729-7664

Interoperability endpoints

  • Direct secure messaging: sbyrne@vitalskinderm.emadirect.md

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1386192300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13802 LAKE POINT CIR STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234219",
            "telephone_number": "502-245-4450",
            "fax_number": "502-245-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13802 LAKE POINT CIR STE 102",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234219",
            "telephone_number": "502-245-4450",
            "fax_number": "502-245-4462"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Hurstbourne Village Dr Ste 900",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402991851",
            "country_code": "US",
            "telephone_number": "502-245-4450",
            "fax_number": "502-245-4462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BYRNE",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-19",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3010706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.