NPIMap

Individual provider Active NPI

Jamie M Niehaus, APRN

  • Family Nurse Practitioner
  • Leitchfield, KY
National Provider Identifier
1629611843
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3013963 Issued in KY
Practice address
912 Wallace Ave
Leitchfield, KY 42754-2404
Phone
(270) 259-9316
Fax
(270) 259-6571
NPI assigned
Oct 21, 2019
Last updated
Oct 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3013963 KY Primary

Addresses

Primary practice location

912 Wallace Ave
Leitchfield, KY 42754-2404

Mailing address

908 Wallace Ave
Leitchfield, KY 42754-1479
Phone (270) 259-9580

Other identifiers 1

IdentifierTypeStateIssuer
7100632280MedicaidKY

Other names 1

  • Jamie Allen Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191202002623 KY Practitioner - Nurse Practitioner 8628401858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT Pros, IncGroup PAC ID 0143139337, shared by 14 NPIs, 263 clinicians

Practice addresses (Care Compare)

201 S Main St
Leitchfield, KY 42754-1425
Phone (270) 230-1729

912 Wallace Ave
Suite 101
Leitchfield, KY 42754-2405
Phone (270) 259-9316

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3013963KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group, Inc. Family CurrentSince Jan 1, 2021 Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group Inc Family CurrentSince Jan 1, 2021 Accepting new patients
Owensboro Health Medical Group, Inc Family Past Accepting new patients

Locations

912 Wallace Ave
Ste 101
Leitchfield, KY 42754
Phone (270) 259-9316

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

Interoperability endpoints

  • Direct secure messaging: jniehaus110671@direct.owensborohealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1629611843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 WALLACE AVE",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427541479",
            "telephone_number": "270-259-9580",
            "fax_number": "270-259-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 WALLACE AVE",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427542404",
            "telephone_number": "270-259-9316",
            "fax_number": "270-259-6571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEHAUS",
        "first_name": "JAMIE",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100632280",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "ALLEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leitchfield, KY

Sources for this page

Verify at the official NPI Registry.