NPIMap

Individual provider Active NPI

Jacqueline M. Guetig, APRN

  • Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1467653550
Registry record updated Nov 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3004541 Issued in KY
Practice address
7430 Jefferson Blvd
Suite 100
Louisville, KY 40219-6159
Phone
(502) 969-0975
Fax
(502) 969-0081
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4541P KY
Occupational Health Nurse Practitioner 363LX0106X 71001870C IN
Nurse Practitioner 363L00000X 3004541 KY Primary

Addresses

Primary practice location

7430 Jefferson Blvd
Suite 100
Louisville, KY 40219-6159

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other identifiers 1

IdentifierTypeStateIssuer
71000857MedicaidKY

Other names 1

  • Ms. Jacqueline Ray Manion Other name

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
I20090808000018 KY Practitioner - Nurse Practitioner 7315090354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

7430 Jefferson Blvd
Louisville, KY 40219-6159

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Hospital & facility affiliations

  • Vna Health at Home Home health agency, Louisville, KY, CCN 187000
  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088
  • UOFL HEALTH - JEWISH HOSPITAL and Mary & Elizabeth Hospital Hospital, Louisville, KY, CCN 180040

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4541PKYMDNurse Practitioner
71001870CINMDOccupational Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Aug 1, 2014 Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner Current Accepting new patients
Community Medical Associates, Inc. Nurse Practitioner CurrentSince Aug 1, 2014 Accepting new patients

Locations

1250 Bardstown Rd
Louisville, KY 40204
Phone (502) 456-7047

7430 Jefferson Blvd
#200
Louisville, KY 40219
Phone (502) 966-8675

7430 Jefferson Blvd
#100
Louisville, KY 40219
Phone (502) 969-0875

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Interoperability endpoints

  • Direct secure messaging: jguetig73571@direct.nortonhealthcare.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 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542931200000",
    "number": "1467653550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7430 JEFFERSON BLVD",
            "address_2": "SUITE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402196159",
            "telephone_number": "502-969-0975",
            "fax_number": "502-969-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUETIG",
        "first_name": "JACQUELINE",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-29",
        "last_updated": "2018-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "4541P",
            "primary": false
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "IN",
            "license": "71001870C",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3004541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "71000857",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "MANION",
            "middle_name": "RAY",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.