Shanna D. Kozak, APRN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3006749 Issued in KY

Practice address

250 Park Street
Bowling Green, KY 42101-1780

Phone

(270) 796-6540

Fax

(270) 796-6576

NPI assigned

Mar 10, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Commonwealth Health Corporation, Inc

  • Neurology Physician
  • Bowling Green, KY
  • NPI 1881109304

  Nurse Practitioner

  Medicare reassignment NPD
• Commonwealth Health Corporation, Inc.

  • Plastic and Reconstructive Surgery Physician
  • Bowling Green, KY
  • NPI 1104470699
  NPD
• Commonwealth Health Corporation, Inc.

  • Hospitalist Physician
  • Bowling Green, KY
  • NPI 1205085495

  Nurse Practitioner

  NPD
• Premier Hospitalist Associates, PLLC

  • Hospitalist Physician
  • Hendersonville, TN
  • NPI 1912242108
  NPD
• Hendersonville Hospitalist Services Inc

  • Hospitalist Physician
  • Hendersonville, TN
  • NPI 1750370797
  NPD (past)

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

{
    "created_epoch": "1299715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385510400000",
    "number": "1497053714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PARK STREET",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011780",
            "telephone_number": "270-796-6540",
            "fax_number": "270-796-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PARK STREET",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011780",
            "telephone_number": "270-796-6540",
            "fax_number": "270-796-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZAK",
        "first_name": "SHANNA",
        "middle_name": "D.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-10",
        "last_updated": "2013-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "15685",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "3006749",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3006749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abby Koon
• Kelly Koons
• John L. Korba, MD
• Bryan Matthew Korgan, CRNA
• Mary F Kovar, APRN
• Dana Clare Kramer, OT
• Christian Michael Kranz, CRNA
• Kelly E Kries, MD
• Alexis M Kriete, BS, RBT
• Hannah Beth Krisher, MA, LPA

• Nurse Practitioner in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.