Individual provider Active NPI

Jessica N B Easterling, M.D

  • Pediatrics Physician
  • Shelbyville, KY
National Provider Identifier
1669656849
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
43516 Issued in KY
Practice address
150 Frankfort Rd Ste 101
Shelbyville, KY 40065-7401
Phone
(502) 647-5468
Fax
(502) 732-7136
NPI assigned
Dec 23, 2007
Last updated
Feb 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 43516 KY Primary
Pediatric Sports Medicine Physician 2080S0010X 43516 KY

Addresses

Primary practice location

150 Frankfort Rd Ste 101
Shelbyville, KY 40065-7401

Mailing address

PO Box 776879
Chicago, IL 60677-1435
Phone (502) 588-9490

Other identifiers 1

IdentifierTypeStateIssuer
7100174360MedicaidKY

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111205000346 KY Practitioner - Pediatric MedicinePractitioner - Sports Medicine 6002081916 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Childrens Medical Group, LLC Pediatrics CurrentSince Mar 1, 2024 Accepting new patients
Norton Children's Medical Group, LLC Current Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Mar 1, 2024 Accepting new patients

Locations

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

150 Frankfort Rd
Ste 101
Shelbyville, KY 40065
Phone (502) 647-5468

Interoperability endpoints

  • Direct secure messaging: jeasterling84765@direct.nortonhealthcare.org

Organizations & group practices 3

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": "1198368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1669656849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606771435",
            "telephone_number": "502-588-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 FRANKFORT RD STE 101",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400657401",
            "telephone_number": "502-647-5468",
            "fax_number": "502-732-7136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTERLING",
        "first_name": "JESSICA",
        "middle_name": "N B",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-23",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "43516",
            "primary": true
        },
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "KY",
            "license": "43516",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100174360",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, KY

Sources for this page

Verify at the official NPI Registry.