Jackie Stethem

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3013689 Issued in KY

Practice address

3050 Rio Dosa Dr
Lexington, KY 40509-1540

Phone

(859) 269-2325

NPI assigned

May 30, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ridge Outpatient Counseling, LLCGroup PAC ID 5991690471, 7 clinicians

Bluegrass Counseling and Trauma ServicesGroup PAC ID 0042693137, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Bluegrass Counseling & Trauma Services

  • Mental Health Counselor
  • Lexington, KY
  • NPI 1366197147
  Medicare reassignment Care Compare group NPD
• Ridge Outpatient Counseling, LLC

  • Psychiatric Hospital Unit
  • Lexington, KY
  • NPI 1922214956

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Uhs of Ridge LLC

  • Psychiatric Hospital
  • Lexington, KY
  • NPI 1316917198
  NPD (past)

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1740848324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3050 RIO DOSA DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091540",
            "telephone_number": "859-269-2325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 RIO DOSA DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405091540",
            "telephone_number": "859-269-2325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STETHEM",
        "first_name": "JACKIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3013689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stepworks Recovery Centers LLC
• Ashley Sterling
• Stephen Jerome Sterlitz, DDS
• Susan F Stern, OTR/L
• Chad Sterrett
• Steve Marcum PT, LLC
• Steven Klecker
• Danelle J Stevens-Watkins, PH.D.
• Dalton Clay Stevens, PT
• Emily Layne Stevens, PA-C

• Psychiatric/Mental Health Nurse Practitioner in Lexington, KY
• Providers in Lexington, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.