Individual provider Active NPI

Jennifer Dorriety

  • Family Nurse Practitioner
  • Shepherdsville, KY
National Provider Identifier
1730865593
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4005981 Issued in KY
Practice address
185 Adam Shepherd Pkwy
Shepherdsville, KY 40165-6578
Phone
(502) 921-5450
NPI assigned
Jun 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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 4005981 KY Primary

Addresses

Primary practice location

185 Adam Shepherd Pkwy
Shepherdsville, KY 40165-6578

Mailing address

75 Lincoln Dr
Elizabethtown, KY 42701-9720
Phone (364) 203-1506

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
I20230824002623 KY Practitioner - Nurse Practitioner 5092178970 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

315 Hospital Dr
Suite 2
Barbourville, KY 40906-7917
Phone (606) 546-4060

Merit-based Incentive Payment System (MIPS)

Final score
83.72 of 100Reported as group
Quality
66.02
Promoting interoperability
100
Improvement activities
40
Cost
79.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4005981KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Barbourville Family Health Center Current Accepting new patients
Barbourville Family Health Center CurrentSince Jun 3, 2024 Accepting new patients
Kiosk Medicine Kentucky LLC Family CurrentSince Jul 3, 2023 Accepting new patients
Barbourville Family Health Center Past Accepting new patients

Locations

315 Hospital Dr
Ste 2
Barbourville, KY 40906
Phone (606) 546-4060

215 N Allison Ave
Barbourville, KY 40906
Phone (606) 546-9287

140 Bryan Blvd
Corbin, KY 40701
Phone (606) 523-2005

3039 Breckenridge Ln
Louisville, KY 40220
Phone (502) 451-4555

185 Adam Shepherd Pkwy
Shepherdsville, KY 40165
Phone (502) 543-7247

Interoperability endpoints

  • Direct secure messaging: jennifer.dorriety@krogerhealth.eclinicaldirectplus.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1730865593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 LINCOLN DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427019720",
            "telephone_number": "364-203-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 ADAM SHEPHERD PKWY",
            "city": "SHEPHERDSVILLE",
            "state": "KY",
            "postal_code": "401656578",
            "telephone_number": "502-921-5450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORRIETY",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4005981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shepherdsville, KY

Sources for this page

Verify at the official NPI Registry.