Individual provider Active NPI

Kimberly Ann Marshall, APRN

  • Nurse Practitioner
  • Owensboro, KY
National Provider Identifier
1386971075
Registry record updated May 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3003659 Issued in KY
Practice address
1201 Pleasant Valley Rd
Owensboro, KY 42303-9811
Phone
(270) 417-4700
Fax
(270) 417-4709
NPI assigned
Nov 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3003659 KY Primary

Addresses

Primary practice location

1201 Pleasant Valley Rd
Owensboro, KY 42303-9811

Mailing address

PO Box 23229
Owensboro, KY 42304-3229
Phone (270) 688-1330

Other identifiers 2

IdentifierTypeStateIssuer
7100096670MedicaidKY
200972960MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmarshall7619@direct.owensborohealth.org

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
I20091231000388 KY Practitioner - Nurse Practitioner 1850432535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Owensboro Health Medical Group IncGroup PAC ID 0648255034, 455 clinicians

Practice addresses (Care Compare)

1201 Pleasant Valley Rd
Owensboro, KY 42303-9811

1301 Pleasant Valley Rd
Owensboro, KY 42303-9774

2211 Mayfair Dr
Owensboro, KY 42301-4569

Hospital & facility affiliations

  • Owensboro Health Regional Hospital Hospital, Owensboro, KY, CCN 180038

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3003659KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group, Inc Nurse Practitioner CurrentSince Nov 22, 2009 Accepting new patients
Owensboro Health Medical Group Inc CurrentSince Nov 22, 2009 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients

Locations

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-2000

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

Interoperability endpoints

  • Direct secure messaging: kmarshall7619@direct.owensborohealth.org

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.

Hospital & facility affiliations 1

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": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557792000000",
    "number": "1386971075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23229",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423043229",
            "telephone_number": "270-688-1330",
            "fax_number": "270-688-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 PLEASANT VALLEY RD",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423039811",
            "telephone_number": "270-417-4700",
            "fax_number": "270-417-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-17",
        "last_updated": "2019-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3003659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100096670",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200972960",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmarshall7619@direct.owensborohealth.org",
            "affiliation": "N",
            "address_1": "1201 Pleasant Valley Rd",
            "city": "Owensboro",
            "state": "KY",
            "country_code": "US",
            "postal_code": "423039811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.