Jessica A Combs, APRN
Individual provider Active NPI Pediatric Nurse Practitioner · Glasgow, KY
NPI 1679976518 · NPPES record last updated Oct 26, 2015
Key facts
- NPI
- 1679976518
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Nurse Practitioner 363LP0200X
- License
- 3008912 (KY)
- Practice address
- 301 Professional Park Dr
Glasgow, KY 42141-3487 - Phone
- (270) 651-9696
- Fax
- (270) 651-0385
- NPI assigned
- Oct 7, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150225002162 | KY | Practitioner - Nurse Practitioner | 3678899283 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3008912 | KY | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cumberland Family Medical Center Inc | Current |
Accepting new patients | |
| Cumberland Family Medical Center Inc | Past | Accepting new patients |
Locations
301 Professional Park Dr
Glasgow, KY 42141
Phone (270) 651-5004
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 3008912 | KY | Yes |
Addresses
Primary practice location
301 Professional Park Dr
Glasgow, KY 42141-3487
Mailing address
PO Box 1080
Burkesville, KY 42717-1080
Phone (270) 864-1472
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100336280 | Medicaid | KY |
Other names
- Jessica A Mitchell
Other providers in Glasgow, KY
- James M. Clements
- Amber Cline
- Richard M Clouse
- Ashley L Collins
- Elizabeth L Combs Royse
- Katherine Combs
- Commonwealth of Kentucky
- Commonwealth Pain Associates PLLC
- Commonwealth Pain Associates PLLC
- Community Emergency Physicians, PLLC
All providers in Glasgow, KY · Pediatric Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.