Individual provider Active NPI

Kaile Gardner

  • Family Nurse Practitioner
  • Hopkinsville, KY
National Provider Identifier
1700543360
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3016591 Issued in KY
Practice address
320 W 18TH St
Hopkinsville, KY 42240-1965
Phone
(270) 887-0100
NPI assigned
Nov 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 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 3016591 KY Primary

Addresses

Primary practice location

320 W 18TH St
Hopkinsville, KY 42240-1965

Mailing address

320 W 18TH St
Hopkinsville, KY 42240-1965

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
I20211230000680 KY Practitioner - Nurse Practitioner 7214328202 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jennie Stuart Medical Center IncGroup PAC ID 4183607252, 113 clinicians

Practice addresses (Care Compare)

10755 Eagle Way
Suite 201
Hopkinsville, KY 42240-8742
Phone (270) 807-5430

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3016591KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jennie Stuart Medical Center Inc CurrentSince Dec 5, 2022 Accepting new patients
Jennie Stuart Medical Center Inc CurrentSince Dec 5, 2022 Accepting new patients
Jennie Stuart Medical Center Inc Family Current Accepting new patients
Jennie Stuart Medical Center Past Accepting new patients

Locations

10755 Eagle Way
Ste 201
Hopkinsville, KY 42240
Phone (270) 807-5430

320 W 18th St
Hopkinsville, KY 42240
Phone (270) 887-0100

10755 Eagle Way
Ste 202
Hopkinsville, KY 42240
Phone (270) 887-5640

Interoperability endpoints

  • Direct secure messaging: kgardner1012112@direct.deaconess.com

Organizations & group practices 4

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": "1637193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1700543360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 W 18TH ST",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422401965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 W 18TH ST",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422401965",
            "telephone_number": "270-887-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "KAILE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-18",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3016591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopkinsville, KY

Sources for this page

Verify at the official NPI Registry.