Carolyn R Fegenbush, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71001579A Issued in IN

Practice address

1802 E 10TH St
Jeffersonville, IN 47130-6016

Phone

(812) 288-2488

Fax

(770) 573-9513

NPI assigned

Jul 6, 2006

Last updated

Nov 8, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, KY2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Clark Medical Group LLCGroup PAC ID 3971879354, 21 clinicians

Zilmed LLCGroup PAC ID 9133465941, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Nazareth Home Inc

  • Skilled Nursing Facility
  • Louisville, KY
  • NPI 1346312824

  Corporate Director

  CMS ownership
• Nazareth Home, Inc.

  dba Sacred Heart Home of Louisville

  • Skilled Nursing Facility
  • Louisville, KY
  • NPI 1205292893

  Corporate Director

  CMS ownership

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.

• North Clark Medical Group LLC

  • General Practice Physician
  • Jeffersonville, IN
  • NPI 1376095711

  Addiction Medicine, KY

  Medicare reassignment Care Compare group NPD
• Zilmed LLC

  • Family Medicine Physician
  • Jeffersonville, IN
  • NPI 1083131957

  KY

  Medicare reassignment Care Compare group
• Nazareth Home, Inc.

  dba Sacred Heart Home of Louisville

  • Skilled Nursing Facility
  • Louisville, KY
  • NPI 1205292893
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1629009790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 MARKET ST STE 101",
            "city": "CHARLESTOWN",
            "state": "IN",
            "postal_code": "471119535",
            "telephone_number": "812-503-5100",
            "fax_number": "770-573-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 E 10TH ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471306016",
            "telephone_number": "812-288-2488",
            "fax_number": "770-573-9513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 Short St",
            "address_purpose": "LOCATION",
            "city": "Charlestown",
            "state": "IN",
            "postal_code": "471111241",
            "country_code": "US",
            "telephone_number": "812-503-5100",
            "fax_number": "770-573-9513",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1804 E 10th St",
            "address_purpose": "LOCATION",
            "city": "Jeffersonville",
            "state": "IN",
            "postal_code": "471306016",
            "country_code": "US",
            "telephone_number": "812-288-2488",
            "fax_number": "770-573-9513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEGENBUSH",
        "first_name": "CAROLYN",
        "middle_name": "R",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "IN",
            "license": "71001579A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001579A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Health Center of Clark County, Inc. (Family Health Centers of Southern Indiana)
• Family Medicine of Southern Indiana
• Megan Farmer, RBT
• Lindasue Farrell, LCSW
• Jena Fath, RBT
• Diane Ferree
• Asia Fields
• Joyce Audrey Fields
• Madison J Fields, SLP
• Ann Lauren Fiepke

• Nurse Practitioner in Jeffersonville, IN
• Providers in Jeffersonville, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.