Individual provider Active NPI

Kayla Jordan Pridemore

  • Inpatient Obstetric Registered Nurse
  • Jenkins, KY
National Provider Identifier
1578427670
Registry record updated Dec 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Inpatient Obstetric Registered NurseTaxonomy code 163WX0003X
License
1141181 Issued in KY
Practice address
61 Crosby Drive
Jenkins, KY 41537
Phone
(606) 872-1745
NPI assigned
Dec 12, 2025
Last updated
Dec 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Inpatient Obstetric Registered Nurse 163WX0003X 1141181 KY Primary

Addresses

Primary practice location

61 Crosby Drive
Jenkins, KY 41537

Mailing address

PO Box 90
Pine Top, KY 41843-0090

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

State licenses

LicenseStateTypeSpecialty
1141181KYMDInpatient Obstetric Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1765497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765497600000",
    "number": "1578427670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90",
            "city": "PINE TOP",
            "state": "KY",
            "postal_code": "418430090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 CROSBY DRIVE",
            "city": "JENKINS",
            "state": "KY",
            "postal_code": "41537",
            "telephone_number": "606-872-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIDEMORE",
        "first_name": "KAYLA",
        "middle_name": "JORDAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-12-12",
        "last_updated": "2025-12-12",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Obstetric, Inpatient",
            "state": "KY",
            "license": "1141181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenkins, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.