Individual provider Active NPI

Marcy Dawn Mabry

  • Family Nurse Practitioner
  • Hopkinsville, KY
National Provider Identifier
1699205476
Registry record updated May 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3011380 Issued in KY
Practice address
2955 Fort Campbell Blvd
Hopkinsville, KY 42240-4901
Phone
(270) 985-3015
NPI assigned
Jun 14, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2021

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 3011380 KY Primary

Addresses

Primary practice location

2955 Fort Campbell Blvd
Hopkinsville, KY 42240-4901

Mailing address

230 N Green St
Henderson, KY 42420-3109
Phone (270) 854-3196

Other names 1

  • Marcy Dawn Smith Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180927002666 KY Practitioner - Nurse Practitioner 0244581353 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fast Pace Kentucky, PLLCGroup PAC ID 0143525998, 213 clinicians

Practice addresses (Care Compare)

1151 W 9TH St
Russellville, KY 42276-9760
Phone (270) 847-4033

Hospital & facility affiliations

  • Deaconess Henderson Hospital Hospital, Henderson, KY, CCN 180056

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Kentucky, PLLC CurrentSince Jan 1, 2025 Accepting new patients
Fast Pace Kentucky PLLC CurrentSince Jul 25, 2018 Accepting new patients
Brock Medical, LLC CurrentSince Jul 25, 2018 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 1, 2025 Accepting new patients
Fast Pace Kentucky PLLC Family CurrentSince Jan 1, 2025 Accepting new patients
Fast Pace Kentucky, PLLC Past Accepting new patients

Locations

110 W John Rowan Blvd
Bardstown, KY 40004
Phone (502) 337-7409

401 Main St
Benton, KY 42025
Phone (270) 906-0369

1475 Nashville Rd
Franklin, KY 42134
Phone (270) 813-1111

237 N L Rogers Wells Blvd
Glasgow, KY 42141
Phone (270) 861-1110

230 N Green St
Henderson, KY 42420
Phone (270) 854-3196

805 S Lincoln Blvd
Hodgenville, KY 42748

2955 Fort Campbell Blvd
Hopkinsville, KY 42240
Phone (270) 348-3677

1649 Highway 192 W
London, KY 40741
Phone (606) 330-0055

1151 W 9th St
Russellville, KY 42276
Phone (270) 847-4033

115 Tradepark Dr
Ste A
Somerset, KY 42503
Phone (606) 678-5708

Organizations & group practices 7

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.

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": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1699205476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N GREEN ST",
            "city": "HENDERSON",
            "state": "KY",
            "postal_code": "424203109",
            "telephone_number": "270-854-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2955 FORT CAMPBELL BLVD",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422404901",
            "telephone_number": "270-985-3015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABRY",
        "first_name": "MARCY",
        "middle_name": "DAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3011380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCY",
            "last_name": "SMITH",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hopkinsville, KY

Sources for this page

Verify at the official NPI Registry.