Individual provider Active NPI

Gradaphene I Hayden, FNP-C

  • Family Nurse Practitioner
  • Scottsville, KY
National Provider Identifier
1649929811
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3017577 Issued in KY
Practice address
12 Sunshine LN
Scottsville, KY 42164-7962
Phone
(904) 598-4622
NPI assigned
Mar 23, 2022
Last updated
Jun 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP.AP.70138382-NP WA
Family Nurse Practitioner 363LF0000X 3017577 KY Primary
Nurse Practitioner 363L00000X 3017577 KY

Addresses

Primary practice location

12 Sunshine LN
Scottsville, KY 42164-7962

Mailing address

12 Sunshine LN
Scottsville, KY 42164-7962
Phone (904) 598-4622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, TN, MI3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20220426000489 KY Practitioner - Nurse Practitioner 3173910957 Reassigns benefits to 3 organizations
I20251010000005 TN Practitioner - Nurse Practitioner 3173910957 Reassigns benefits to 1 organization
I20260608002945 MI Practitioner - Nurse Practitioner 3173910957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11780 US Hwy 1
Suite N107
North Palm Beach, FL 33408

12 Sunshine LN
Scottsville, KY 42164-7962

200 Oceangate
Suite 100
Long Beach, CA 90802-4316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3017577KYMDNurse Practitioner
ARNP.AP.70138382-NPWAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Longevity Clinical LTC Associates of Tennessee, PLLC CurrentSince Jul 28, 2025 Accepting new patients
Molina Care Connections, LLC. Nurse Practitioner CurrentSince Feb 6, 2026 Accepting new patients
Fast Pace Kentucky PLLC Family CurrentSince Dec 1, 2022 Accepting new patients
Zipclinic, PSC CurrentSince May 15, 2024 Accepting new patients
Longevity Clinical LTC Associates of Kentucky, PLLC CurrentSince Jul 28, 2025 Accepting new patients
Fast Pace Kentucky, PLLC CurrentSince Dec 1, 2022 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

2508 Scottsville Rd
Ste 104
Bowling Green, KY 42104
Phone (270) 746-6330

2005 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 360-0008

1475 Nashville Rd
Franklin, KY 42134
Phone (270) 813-1111

2100 Cherokee Ridge Way
Louisville, KY 40205
Phone (502) 451-0990

5100 Commerce Crossings Dr
Louisville, KY 40229
Phone (502) 305-6267

1350 N Main St
Madisonville, KY 42431
Phone (270) 245-2554

880 W Long Lake Rd
Troy, MI 48098
Phone (248) 227-6316

309 Main St
Red Boiling Springs, TN 37150
Phone (270) 487-9272

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1649929811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 SUNSHINE LN",
            "city": "SCOTTSVILLE",
            "state": "KY",
            "postal_code": "421647962",
            "telephone_number": "904-598-4622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 SUNSHINE LN",
            "city": "SCOTTSVILLE",
            "state": "KY",
            "postal_code": "421647962",
            "telephone_number": "904-598-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDEN",
        "first_name": "GRADAPHENE",
        "middle_name": "I",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "ARNP.AP.70138382-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3017577",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3017577",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsville, KY

Sources for this page

Verify at the official NPI Registry.