Individual provider Active NPI

Kennadi Brooklyn Thompson

  • Student in an Organized Health Care Education/Training Program
  • Shepherdsville, KY
National Provider Identifier
1710892971
Registry record updated Aug 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
I17123 Issued in KY
Practice address
509 Mallard Lake Blvd
Shepherdsville, KY 40165-5384
Phone
(502) 681-6969
NPI assigned
Aug 14, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X I17123 KY Primary

Addresses

Primary practice location

509 Mallard Lake Blvd
Shepherdsville, KY 40165-5384

Mailing address

509 Mallard Lake Blvd
Shepherdsville, KY 40165-5384
Phone (502) 681-6969

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

NPI Registry JSON

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

{
    "created_epoch": "1786665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1710892971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 MALLARD LAKE BLVD",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401655384",
            "telephone_number": "502-681-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 MALLARD LAKE BLVD",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401655384",
            "telephone_number": "502-681-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KENNADI",
        "middle_name": "BROOKLYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-14",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KY",
            "license": "I17123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shepherdsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; 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.