Kristie Lee Brackett, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

71011639A Issued in IN

Practice address

711 Saint Marys Dr
Evansville, IN 47714-0508

Phone

(812) 476-4362

Fax

(812) 469-3700

NPI assigned

Oct 12, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent Evansville Hospital, Evansville, IN, CCN 150100
• Wabash General Hospital 1 Hospital, Mount Carmel, IL, CCN 141327

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• St Mary'S Medical Group, LLC

  • Family Medicine Physician
  • Evansville, IN
  • NPI 1164852539
  Medicare reassignment Care Compare group NPD
• St Mary'S Medical Group, LLC

  • Nephrology Physician
  • Evansville, IN
  • NPI 1619307873
  NPD
• St. Mary'S Health, Inc

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1497706287
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Mary'S Health, Inc.

  • General Acute Care Hospital
  • Evansville, IN
  • NPI 1427082957
  Care Compare affiliation
• Wabash General Hospital District

  • Critical Access Hospital
  • Mount Carmel, IL
  • NPI 1194728808
  Care Compare affiliation
• Wabash General Hospital District

  • Ambulance
  • Mount Carmel, IL
  • NPI 1194814178

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1790447175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 SAINT MARYS DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140508",
            "telephone_number": "812-476-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 SAINT MARYS DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140508",
            "telephone_number": "812-476-4362",
            "fax_number": "812-469-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKETT",
        "first_name": "KRISTIE",
        "middle_name": "LEE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-12",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IN",
            "license": "71011639A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71011639A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kristie.brackett.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "711 Saint Marys Dr",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477140508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew M Boyer, MD
• Addison McKinley Boyle
• Christopher W Brackett, OD
• Eric Brackett, MD
• Jordyn Leanne Brackett, PMHNP
• Logan L Bradbury, PMHNP
• Angela Kay Bradford-Heidorn, LCSW, LCAC
• Jordan Bradley
• Linda Leigh Brady, PA-C
• Mark Roland Brady, C.C.P.

• Gerontology Nurse Practitioner in Evansville, IN
• Providers in Evansville, IN by specialty
• Gerontology Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2022; 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.