Individual provider Active NPI

Kalyan Subedi

  • Psychiatric/Mental Health Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1679973580
Registry record updated Jan 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3008883 Issued in KY
Practice address
1135 Twilight Shadow Dr
Lexington, KY 40509-4298
Phone
(334) 268-9380
NPI assigned
Aug 27, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1123681 KY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP70086037 WA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3008883 KY Primary

Addresses

Primary practice location

1135 Twilight Shadow Dr
Lexington, KY 40509-4298

Mailing address

1135 Twilight Shadow Dr
Lexington, KY 40509-4298
Phone (334) 268-9380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, WA, CO3 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
I20141021001554 KY Practitioner - Nurse Practitioner 8325269178 Reassigns benefits to 4 organizations
I20260130003114 WA Practitioner - Nurse Practitioner 8325269178 Reassigns benefits to 1 organization
I20260224002963 CO Practitioner - Nurse Practitioner 8325269178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rivervalley Behavioral Health IncGroup PAC ID 4082522396, 22 clinicians

Practice addresses (Care Compare)

1100 Walnut St
Owensboro, KY 42301-2956
Phone (270) 689-6500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1123681KYMDRegistered Nurse
3008883KYMDPsychiatric/Mental Health Nurse Practitioner
AP70086037WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Psychiatric/Mental Health CurrentSince Dec 10, 2024 Accepting new patients
Mental Health Specialty Group PA CurrentSince May 1, 2025 Accepting new patients

Locations

5445 Dtc Pkwy
Ph 4
Greenwood Village, CO 80111
Phone (720) 571-4874

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023

312 S 4th St
Louisville, KY 40202
Phone (502) 213-5590

1100 Walnut St
Owensboro, KY 42301
Phone (270) 689-6500

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768521600000",
    "number": "1679973580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 TWILIGHT SHADOW DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405094298",
            "telephone_number": "334-268-9380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 TWILIGHT SHADOW DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405094298",
            "telephone_number": "334-268-9380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBEDI",
        "first_name": "KALYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-27",
        "last_updated": "2026-01-16",
        "certification_date": "2026-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1123681",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP70086037",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3008883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.