Individual provider Active NPI

Karen K Nalle, PA

  • Physician Assistant
  • Somerset, KY
National Provider Identifier
1598743460
Registry record updated Jul 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA924 Issued in KY
Practice address
259 Parkers Mill Rd
Somerset, KY 42501-3152
Phone
(606) 679-4782
NPI assigned
Jan 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA924 KY Primary

Addresses

Primary practice location

259 Parkers Mill Rd
Somerset, KY 42501-3152

Mailing address

130 Southern School Rd
Somerset, KY 42501-3223
Phone (606) 679-4782

Other practice location 1

90 Medical Ln
Whitley City, KY 42653-4216
Phone (606) 376-2466

Other identifiers 1

IdentifierTypeStateIssuer
95005732MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050922000232 KY Practitioner - Physician Assistant 7416909536 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Cumberland Regional MHMR Board Outpatient Past Accepting new patients
Commonwealth of Kentucky Past Accepting new patients
Lake Cumberland Physician Practices LLC Physician Assistant Past Accepting new patients

Organizations & group practices 4

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": "1136160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594166400000",
    "number": "1598743460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 SOUTHERN SCHOOL RD",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425013223",
            "telephone_number": "606-679-4782",
            "fax_number": "606-677-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 PARKERS MILL RD",
            "city": "SOMERSET",
            "state": "KY",
            "postal_code": "425013152",
            "telephone_number": "606-679-4782"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "90 Medical Ln",
            "address_purpose": "LOCATION",
            "city": "Whitley City",
            "state": "KY",
            "postal_code": "426534216",
            "country_code": "US",
            "telephone_number": "606-376-2466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NALLE",
        "first_name": "KAREN",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-02",
        "last_updated": "2020-07-08",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95005732",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, KY

Sources for this page

Verify at the official NPI Registry.