Active NPI
Martha June Kloss, ARNP
- Family Nurse Practitioner
- Paducah, KY
National Provider Identifier
1629030465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- ARNP 3987P
- Practice address
- 225 Medical Center Dr
Ste. 304
Paducah, KY 42003-7914 - Phone
- (270) 441-4301
- Fax
- (270) 441-4739
- NPI assigned
- Apr 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | ARNP 3987P | KY | Primary |
Addresses
Primary practice location
225 Medical Center Dr
Ste. 304
Paducah, KY 42003-7914
Mailing address
225 Medical Center Dr
Ste. 304
Paducah, KY 42003-7914
Phone (270) 441-4301
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78010808 | Medicaid | KY |
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)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ARNP 3987P | KY | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Ophthalmology Group, LLC | Current | Accepting new patients | |
| Purchase Derm-ENT, PLLC | Family | Past | Accepting new patients |
Locations
4630 Village Square Dr
Ste 102
Paducah, KY 42001
Phone (270) 443-4393
4630 Village Square Dr
Paducah, KY 42001
Phone (270) 442-1671
Organizations & group practices 2
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.
-
- Ophthalmology Physician
- Paducah, KY
- NPI 1598717027
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192579200000",
"number": "1629030465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 MEDICAL CENTER DR",
"address_2": "STE. 304",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420037914",
"telephone_number": "270-441-4301",
"fax_number": "270-441-4739"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 MEDICAL CENTER DR",
"address_2": "STE. 304",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420037914",
"telephone_number": "270-441-4301",
"fax_number": "270-441-4739"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLOSS",
"first_name": "MARTHA",
"middle_name": "JUNE",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-05",
"last_updated": "2007-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": "ARNP 3987P",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "78010808",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Paducah, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.