NPIMap

Individual provider Active NPI

Kelly S Vanbussum, NP

  • Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1417266958
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3006647 Issued in KY
Practice address
1850 Bluegrass Ave Ste 4TH
Louisville, KY 40215-1161
Phone
(502) 367-3360
Fax
(502) 367-3365
NPI assigned
Oct 1, 2010
Last updated
Feb 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 6647P KY
Nurse Practitioner 363L00000X 3006647 KY Primary

Addresses

Primary practice location

1850 Bluegrass Ave Ste 4TH
Louisville, KY 40215-1161

Mailing address

1850 Bluegrass Ave Ste 4TH
Louisville, KY 40215-1161
Phone (502) 367-3360

Other identifiers 1

IdentifierTypeStateIssuer
7100149050MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101123000992 KY Practitioner - Nurse Practitioner 8325234859 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

201 Abraham Flexner Way
Suite 1200
Louisville, KY 40202-3481
Phone (502) 583-8383

4003 Kresge Way
Suite 400
Louisville, KY 40207-4652
Phone (502) 895-4263

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
University of Louisville Physicians, Inc. Nurse Practitioner CurrentSince Nov 1, 2019 Accepting new patients
Baptist Medical Associates Inc CurrentSince Feb 20, 2026 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Feb 20, 2026 Accepting new patients
University of Louisville Physicians Inc. Past Accepting new patients
University of Louisville Research Foundation Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

1850 Bluegrass Ave
Louisville, KY 40215
Phone (502) 361-6617

1850 Bluegrass Ave
Ste 4TH
Louisville, KY 40215

201 Abraham Flexner Way
Ste 1200
Louisville, KY 40202
Phone (502) 583-8383

4003 Kresge Way
Ste 400
Louisville, KY 40207
Phone (502) 895-4263

401 E Chestnut St
Unit 510
Louisville, KY 40202
Phone (502) 588-4800

5100 Outer Loop
Louisville, KY 40219
Phone (502) 968-6226

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

Organizations & group practices 6

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 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551052800000",
    "number": "1417266958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 BLUEGRASS AVE STE 4TH",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151161",
            "telephone_number": "502-367-3360",
            "fax_number": "502-367-3365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 BLUEGRASS AVE STE 4TH",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402151161",
            "telephone_number": "502-367-3360",
            "fax_number": "502-367-3365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANBUSSUM",
        "first_name": "KELLY",
        "middle_name": "S",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-01",
        "last_updated": "2019-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "6647P",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3006647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100149050",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.