Individual provider Active NPI

Jennifer Maupin, CNP

  • Nurse Practitioner
  • Irvine, KY
National Provider Identifier
1760870307
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3010614 Issued in KY
Practice address
1561 Richmond Rd Ste B
Irvine, KY 40336-7235
Phone
(606) 717-0177
NPI assigned
Jan 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X COA.16907-NP OH
Nurse Practitioner 363L00000X 3010614 KY Primary

Addresses

Primary practice location

1561 Richmond Rd Ste B
Irvine, KY 40336-7235

Mailing address

1561 Richmond Rd Ste B
Irvine, KY 40336-7235
Phone (606) 717-0177

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
Certified Nurse Practitioner, Master of Science

State licenses

LicenseStateTypeSpecialty
3010614KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chic CurrentSince Feb 4, 2022 Accepting new patients
Chic Current Accepting new patients

Locations

1561 Richmond Rd
#B
Irvine, KY 40336
Phone (606) 717-0177

920 Richmond Rd
Irvine, KY 40336
Phone (606) 717-0177

Organizations & group practices 2

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": "1420502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1760870307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1561 RICHMOND RD STE B",
            "city": "IRVINE",
            "state": "KY",
            "postal_code": "403367235",
            "telephone_number": "606-717-0177",
            "fax_number": "067-170-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1561 RICHMOND RD STE B",
            "city": "IRVINE",
            "state": "KY",
            "postal_code": "403367235",
            "telephone_number": "606-717-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUPIN",
        "first_name": "JENNIFER",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-06",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "COA.16907-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3010614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.