NPIMap

Organization Active NPI

Kiosk Medicine of Kentucky LLC

  • Family Nurse Practitioner
  • Bellevue, KY
National Provider Identifier
1790220176
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
KIOSK MEDICINE OF KENTUCKY LLC
Practice address
53 Donnermeyer Dr
Bellevue, KY 41073-1394
Phone
(859) 815-7062
Fax
(859) 815-7063
NPI assigned
Dec 21, 2016
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mr. Thomas Shelly
Title
VP & General Manger
Phone
(615) 425-4200

National Provider Directory

National Provider Directory
Tax ID family
Kiosk Medicine Kentucky LLC43 organizations share this tax ID, including this one

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

NPPES NPI Registry

Primary practice location

53 Donnermeyer Dr
Bellevue, KY 41073-1394

Mailing address

PO Box 932958
Cleveland, OH 44193-0028
Phone (615) 425-4200

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
7100455050MedicaidKY

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 21, 2025.

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1790220176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 932958",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441930028",
            "telephone_number": "615-425-4200",
            "fax_number": "615-425-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 DONNERMEYER DR",
            "city": "BELLEVUE",
            "state": "KY",
            "postal_code": "410731394",
            "telephone_number": "859-815-7062",
            "fax_number": "859-815-7063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIOSK MEDICINE OF KENTUCKY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-21",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "SHELLY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "VP & GENERAL MANGER",
        "authorized_official_telephone_number": "615-425-4200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100455050",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; 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.