NPIMap

Individual provider Active NPI

Katrina L Hagan, A.P.R.N.

  • Acute Care Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1609216134
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
3008094 Issued in KY
Practice address
1 Audubon Plaza Dr
Louisville, KY 40217-1318
Phone
(502) 447-8786
Fax
(502) 447-8623
NPI assigned
Jun 28, 2013
Last updated
Sep 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3008094 KY
Acute Care Nurse Practitioner 363LA2100X 3008094 KY Primary
Family Nurse Practitioner 363LF0000X 3008094 KY

Addresses

Primary practice location

1 Audubon Plaza Dr
Louisville, KY 40217-1318

Mailing address

9152 Taylorsville Rd # 276
Louisville, KY 40299-1752
Phone (502) 447-8786

Other identifiers 2

IdentifierTypeStateIssuer
201183870MedicaidIN
7100244950MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130820001040 KY Practitioner - Nurse Practitioner 3072756162 Reassigns benefits to 1 organization
I20131022002173 IN Practitioner - Nurse Practitioner 3072756162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diagnostic X-Ray Physicians, PSCGroup PAC ID 1355239534, 36 clinicians

Practice addresses (Care Compare)

1220 Missouri Ave
Jeffersonville, IN 47130-3725
Phone (502) 447-8786

4001 Dutchmans LN
Louisville, KY 40207-4714
Phone (502) 893-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.52 of 100Reported as group
Quality
100
Improvement activities
40
Cost
91.74

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Diagnostic X-Ray Physicians, PSC Nurse Practitioner CurrentSince Jan 1, 2017 Accepting new patients

Locations

1220 Missouri Ave
Jeffersonvlle, IN 47130
Phone (812) 282-2072

1 Audubon Plaza Dr
Louisville, KY 40217
Phone (502) 634-6767

5129 Dixie Hwy
Ste 100
Louisville, KY 40216
Phone (502) 447-3242

9152 Taylorsville Rd
Louisville, KY 40299
Phone (502) 424-5635

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1372377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1609216134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9152 TAYLORSVILLE RD # 276",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402991752",
            "telephone_number": "502-447-8786",
            "fax_number": "502-447-8623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AUDUBON PLAZA DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171318",
            "telephone_number": "502-447-8786",
            "fax_number": "502-447-8623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "KATRINA",
        "middle_name": "L",
        "credential": "A.P.R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-28",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3008094",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "3008094",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3008094",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201183870",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100244950",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.