Active NPI
Kayla Marie McCormick, RN
- Registered Nurse
- Fort Campbell, KY
National Provider Identifier
1558464453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 0000148840
- Practice address
- 650 Joel Drive
Blanchfield Army Community Hospital
Fort Campbell, KY 42223 - Phone
- (270) 798-8445
- Fax
- (270) 956-0227
- NPI assigned
- Sep 6, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0000148840 | TN | Primary |
Addresses
Primary practice location
650 Joel Drive
Blanchfield Army Community Hospital
Fort Campbell, KY 42223
Mailing address
650 Joel Drive
Blanchfield Army Community Hospital
Fort Campbell, KY 42223
Phone (270) 798-8445
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000148840 | Other | TN | RN LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000148840 | TN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1558464453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 JOEL DRIVE",
"address_2": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "42223",
"telephone_number": "270-798-8445",
"fax_number": "270-956-0227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 JOEL DRIVE",
"address_2": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "42223",
"telephone_number": "270-798-8445",
"fax_number": "270-956-0227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCORMICK",
"first_name": "KAYLA",
"middle_name": "MARIE",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TN",
"license": "0000148840",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "0000148840",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Campbell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.