Individual provider Active NPI

Jacqueline Dennis, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1417351263
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3008879 Issued in KY
Practice address
2400 Eastpoint Pkwy Ste 410
Louisville, KY 40223-4154
Phone
(502) 253-6625
Fax
(502) 253-6629
NPI assigned
Oct 22, 2014
Last updated
Dec 11, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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 3008879 KY Primary

Addresses

Primary practice location

2400 Eastpoint Pkwy Ste 410
Louisville, KY 40223-4154

Mailing address

5200 Commerce Crossings Dr FL 3
Louisville, KY 40229-2182
Phone (502) 253-4924

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdennis9552@bhkydirect.com

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
I20160105001371 KY Practitioner - Nurse Practitioner 2163724345 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2400 Eastpoint Pkwy
Suite 410
Louisville, KY 40223-4154
Phone (502) 897-7411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3008879KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Nov 30, 2015 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Nov 30, 2015 Accepting new patients

Locations

2400 Eastpoint Pkwy
Ste 410
Louisville, KY 40223
Phone (502) 253-6625

2700 Stanley Gault Pkwy
Ste 129
Louisville, KY 40223
Phone (502) 253-4900

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

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 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": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1417351263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 COMMERCE CROSSINGS DR FL 3",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402292182",
            "telephone_number": "502-253-4924",
            "fax_number": "502-489-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 EASTPOINT PKWY STE 410",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402234154",
            "telephone_number": "502-253-6625",
            "fax_number": "502-253-6629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "JACQUELINE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3008879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdennis9552@bhkydirect.com",
            "affiliation": "N",
            "address_1": "2400 Eastpoint Pkwy Ste 410",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402234154",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.