Kathryn Poole
Individual provider Active NPI Family Nurse Practitioner · Paoli, IN
NPI 1689154452 · NPPES record last updated Aug 20, 2018
Key facts
- NPI
- 1689154452
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- F07180820 (IN)
- Practice address
- 420 W Longest St
Paoli, IN 47454-8821 - Phone
- (812) 723-3944
- NPI assigned
- Aug 20, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern Indiana Community Health Care Inc
Practice addresses (Care Compare)
420 W Longest St
Paoli, IN 47454-8821
Phone (812) 723-3944
Hospital & facility affiliations
- Indiana University Health Paoli Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
- 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 |
|---|---|---|---|---|
| I20190225000476 | IN | Practitioner - Nurse Practitioner | 4284973983 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F07180820 | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Indiana Community Health Care, Inc | Current |
Accepting new patients | |
| Southern Indiana Community Health Care, Inc | Past | Accepting new patients | |
| Southern Indiana Community Health Care, Inc | Past | Accepting new patients |
Locations
307 S Indiana Ave
English, IN 47118
Phone (812) 338-2924
5604 E White Oak Ln
Marengo, IN 47140
Phone (812) 365-3221
420 W Longest St
Paoli, IN 47454
Phone (812) 723-3944
1201 N Jim Day Rd
Salem, IN 47167
Phone (812) 723-3944
Interoperability endpoints
- kathrynpoole@sichc.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F07180820 | IN | Yes |
Addresses
Primary practice location
420 W Longest St
Paoli, IN 47454-8821
Mailing address
2943 N County Road 150 E
Paoli, IN 47454-9180
Other providers in Paoli, IN
- Paoli Community School Corporation
- Brenda J Pardy
- Glenn Jay Pedersen
- Personal Counseling LLC
- Ryan Kyle Petty
- Jason Paul Price
- Lynette Price
- Gabriela Amairany Ramirez
- Jasmita Ranchod
- Lolita Ann Reasor-Burton
All providers in Paoli, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2018. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.