Active NPI
Kathy Dianne Phelps, APRN FNP
- Nurse Practitioner
- Paducah, KY
National Provider Identifier
1699863514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3143P
- Practice address
- 3131 Parisa Dr
Paducah, KY 42003-4584 - Phone
- (270) 444-8000
- Fax
- (270) 444-8302
- NPI assigned
- Oct 10, 2006
- Last updated
- Dec 7, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3143P | KY | Primary |
Addresses
Primary practice location
3131 Parisa Dr
Paducah, KY 42003-4584
Mailing address
PO Box 1175
Calvert City, KY 42029
Phone (270) 395-5388
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000340382 | Other | ANTHEM | |
| 78015690 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3143P | KY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Comprehensive Premier Medicine, PLLC | Past | Accepting new patients | |
| Baptist Healthcare System Inc | Past | Accepting new patients | |
| Purchase Care LLC | Past | Accepting new patients |
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.
-
- Community/Retail Pharmacy
- Elizabethtown, KY
- NPI 1497585624
-
- Internal Medicine Physician
- Paducah, KY
- NPI 1437479946
-
- General Practice Physician
- Calvert City, KY
- NPI 1710047998
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354838400000",
"number": "1699863514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1175",
"city": "CALVERT CITY",
"state": "KY",
"postal_code": "42029",
"telephone_number": "270-395-5388",
"fax_number": "270-395-1792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3131 PARISA DR",
"city": "PADUCAH",
"state": "KY",
"postal_code": "420034584",
"telephone_number": "270-444-8000",
"fax_number": "270-444-8302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHELPS",
"first_name": "KATHY",
"middle_name": "DIANNE",
"name_prefix": "Mrs.",
"credential": "APRN FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2012-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "3143P",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000340382",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "78015690",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paducah, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.