Individual provider Active NPI

Carol Sue McLennan, MSN, ARNP, CNS, FNP

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1477601474
Registry record updated Nov 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2757P Issued in KY
Practice address
3505 Hardwood Forest Dr
Louisville, KY 40214-6513
Phone
(502) 419-3794
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1050157 KY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2757S KY
Family Nurse Practitioner 363LF0000X 2757P KY Primary

Addresses

Primary practice location

3505 Hardwood Forest Dr
Louisville, KY 40214-6513

Mailing address

3505 Hardwood Forrest Drive
Lousville, KY 40214
Phone (502) 419-3794

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
I20100430000555 KY Practitioner - Nurse Practitioner 7012045602 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
1050157KYMDRegistered Nurse
2757KYMDSpeech-Language Pathologist
2757PKYMDFamily Nurse Practitioner
2757SKYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kmi Acquisition LLC Psychiatric/Mental Health CurrentSince Jun 10, 2023 Accepting new patients
Kmi Acquisition LLC Current Accepting new patients
United Healthcare of Hardin, Inc Past Accepting new patients
Ava Health and Wellness PLLC Psychiatric/Mental Health Past Accepting new patients
Elderserve, Inc. Past Accepting new patients

Locations

8521 La Grange Rd
Louisville, KY 40242
Phone (502) 426-5648

Organizations & group practices 7

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257724800000",
    "number": "1477601474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 HARDWOOD FORREST DRIVE",
            "city": "LOUSVILLE",
            "state": "KY",
            "postal_code": "40214",
            "telephone_number": "502-419-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 HARDWOOD FOREST DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402146513",
            "telephone_number": "502-419-3794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLENNAN",
        "first_name": "CAROL",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "MSN, ARNP, CNS,  FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2009-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1050157",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "2757S",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "2757P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.