Individual provider Active NPI

Mary Jo Metrick, ARNP MSN

  • Neonatal Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1730120429
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
1040956 Issued in KY
Practice address
571 S Floyd St
Ste 342
Louisville, KY 40202-3818
Phone
(502) 852-8470
NPI assigned
Jun 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 1040956 KY Primary

Addresses

Primary practice location

571 S Floyd St
Ste 342
Louisville, KY 40202-3818

Mailing address

PO Box 909
Louisville, KY 40201-0909
Phone (502) 588-0329

Other identifiers 1

IdentifierTypeStateIssuer
78007366MedicaidKY

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mmetrick53505@direct.nortonhealthcare.org

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
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1040956KYMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neonatal Intensive Care Experts PLLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1730120429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402010909",
            "telephone_number": "502-588-0329",
            "fax_number": "502-588-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 S FLOYD ST",
            "address_2": "STE 342",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402023818",
            "telephone_number": "502-852-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METRICK",
        "first_name": "MARY",
        "middle_name": "JO",
        "credential": "ARNP MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "KY",
            "license": "1040956",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78007366",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmetrick53505@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "571 S Floyd St",
            "address_2": "STE 342",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402023818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Mar 12, 2020; 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.