Individual provider Active NPI

Jessica Dunham, APRN

  • Family Nurse Practitioner
  • Ashland, KY
National Provider Identifier
1598518540
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4015192 Issued in KY
Practice address
613 23Rd St Ste 510
Ashland, KY 41101-2878
Phone
(606) 329-9335
Fax
(606) 324-6383
NPI assigned
Apr 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4015192 KY Primary

Addresses

Primary practice location

613 23Rd St Ste 510
Ashland, KY 41101-2878

Mailing address

PO Box 2379
Ashland, KY 41105-2379

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
I20240712000314 KY Practitioner - Nurse Practitioner 6608311824 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Claire Medical Center IncGroup PAC ID 4486559085, 181 clinicians

Practice addresses (Care Compare)

245 Flemingsburg Rd
Morehead, KY 40351-1015
Phone (606) 780-5500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4015192KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kings Daughters Medical Specialties Inc Current Accepting new patients
Kings Daughters Medical Specialties Inc., CurrentSince Jun 10, 2024 Accepting new patients
Kings Daughters Medical Specialties Inc CurrentSince Jun 10, 2024 Accepting new patients
Kings Daughters Medical Specialties Inc Past Accepting new patients
Sprocket Medical Management LLC Past Accepting new patients

Locations

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

613 23rd St
Ste 510
Ashland, KY 41101

Organizations & group practices 6

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": "1712620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1598518540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2379",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411052379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 23RD ST STE 510",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012878",
            "telephone_number": "606-329-9335",
            "fax_number": "606-324-6383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNHAM",
        "first_name": "JESSICA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-09",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4015192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, KY

Sources for this page

Verify at the official NPI Registry.