Individual provider Active NPI

Kathryn Poole

  • Family Nurse Practitioner
  • Paoli, IN
National Provider Identifier
1689154452
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F07180820 Issued in IN
Practice address
420 W Longest St
Paoli, IN 47454-8821
Phone
(812) 723-3944
NPI assigned
Aug 20, 2018
Last updated
Aug 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F07180820 IN Primary

Addresses

Primary practice location

420 W Longest St
Paoli, IN 47454-8821

Mailing address

2943 N County Road 150 E
Paoli, IN 47454-9180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190225000476 IN Practitioner - Nurse Practitioner 4284973983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

420 W Longest St
Paoli, IN 47454-8821
Phone (812) 723-3944

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F07180820INMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Indiana Community Health Care, Inc CurrentSince Jan 1, 2019 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

  • Direct secure messaging: kathrynpoole@sichc.allscriptsdirect.net

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1689154452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2943 N COUNTY ROAD 150 E",
            "city": "PAOLI",
            "state": "IN",
            "postal_code": "474549180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W LONGEST ST",
            "city": "PAOLI",
            "state": "IN",
            "postal_code": "474548821",
            "telephone_number": "812-723-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "KATHRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "F07180820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, IN

Sources for this page

Verify at the official NPI Registry.