Individual provider Active NPI

Jessica Lorraine Vanover, RN

  • Registered Nurse
  • Louisville, KY
National Provider Identifier
1710555412
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1168448 Issued in KY
Practice address
3001 N Hurstbourne Pkwy
Louisville, KY 40241-2209
Phone
(502) 420-7731
NPI assigned
Jun 17, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1168448 KY Primary

Addresses

Primary practice location

3001 N Hurstbourne Pkwy
Louisville, KY 40241-2209

Mailing address

8906 Wooden Horse Dr
Louisville, KY 40229-6502
Phone (502) 741-2983

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1168448KYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1710555412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8906 WOODEN HORSE DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402296502",
            "telephone_number": "502-741-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 N HURSTBOURNE PKWY",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402412209",
            "telephone_number": "502-420-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANOVER",
        "first_name": "JESSICA",
        "middle_name": "LORRAINE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1168448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.