Jennifer L Gondoly, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3012156 Issued in KY

Practice address

2301 Terra Crossing Blvd Ste 103
Louisville, KY 40245-3909

Phone

(502) 410-0191

Fax

(502) 890-5177

NPI assigned

Dec 30, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

RadiantGroup PAC ID 8426337122, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Lagrange Hospital, La Grange, KY, CCN 180138

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Radiant

  • General Practice Physician
  • Louisville, KY
  • NPI 1831555143

  Family

  Medicare reassignment Care Compare group NPD
• Central Medical Associates PLLC

  • Internal Medicine Physician
  • Elizabethtown, KY
  • NPI 1629461751
  NPD (past)

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

• Baptist Healthcare System, Inc.

  • General Acute Care Hospital
  • La Grange, KY
  • NPI 1306925540
  Care Compare affiliation

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

{
    "created_epoch": "1546128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739664000000",
    "number": "1629540711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17108 HILLROCK PL",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402457560",
            "telephone_number": "517-449-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 TERRA CROSSING BLVD STE 103",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402453909",
            "telephone_number": "502-410-0191",
            "fax_number": "502-890-5177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONDOLY",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-30",
        "last_updated": "2025-02-16",
        "certification_date": "2025-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3012156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystal Gomez, ATC
• Stephen Joseph Gomez, M.D.
• Kabrianna Goncalves, RBT
• Sreedevi Gondi, M.D.
• Dibson Dibe Gondim, M.D.
• Paul H Gong, MD
• Yuan Yuan Gong, M.D.
• Shannon Maureen Gonter, LPCC
• Karen D Gonterman, M.S., CCC-SLP
• Philip Mendoza Gonzales, M.D.

• Family Nurse Practitioner in Louisville, KY
• Providers in Louisville, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; 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.