NPIMap

Individual provider Active NPI

Cari Beth Johnson, APRN, FNP-BC

  • Family Nurse Practitioner
  • Leitchfield, KY
National Provider Identifier
1811338858
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3008167 Issued in KY
Practice address
912 Wallace Ave
Leitchfield, KY 42754-2404
Phone
(270) 259-8888
Fax
(270) 259-8887
NPI assigned
Jul 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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 3008167 KY Primary

Addresses

Primary practice location

912 Wallace Ave
Leitchfield, KY 42754-2404

Mailing address

908 Wallace Ave
Leitchfield, KY 42754-1479
Phone (270) 259-8888

Other identifiers 1

IdentifierTypeStateIssuer
7100299030MedicaidKY

Other names 1

  • Cari Beth Glutting Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140204001468 KY Practitioner - Nurse Practitioner 4880823236 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PT Pros, IncGroup PAC ID 0143139337, shared by 14 NPIs, 263 clinicians

Practice addresses (Care Compare)

201 S Main St
Leitchfield, KY 42754-1425
Phone (270) 230-1729

912 Wallace Ave
Suite 102
Leitchfield, KY 42754-2405
Phone (270) 259-8888

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3008167KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Owensboro Health Medical Group Inc Family CurrentSince Jan 1, 2021 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Sep 1, 2020 Accepting new patients
Owensboro Health Medical Group Inc Family CurrentSince Jan 1, 2021 Accepting new patients
Baptist Health Medical Group Inc Current Accepting new patients
Owensboro Health Medical Group Inc Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince Sep 1, 2020 Accepting new patients
Owensboro Health Medical Group, Inc Family Past Accepting new patients
Mahendra M Patel MD PSC Past Accepting new patients
Central Kentucky Dialysis Centers LLC PastSince Nov 26, 2013 Accepting new patients

Locations

625 W Main St
Clarkson, KY 42726
Phone (270) 242-2311

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

912 Wallace Ave
Ste 102
Leitchfield, KY 42754
Phone (270) 259-2878

2211 Mayfair Dr
Ste 101
Owensboro, KY 42301
Phone (270) 688-1352

2211 Mayfair Dr
Ste 102
Owensboro, KY 42301
Phone (270) 688-1351

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

Interoperability endpoints

  • Direct secure messaging: cjohnson110658@direct.owensborohealth.org
  • Direct secure messaging: cjohnson@hardinmemorial.gwaydirect.com

Organizations & group practices 9

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1373068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1811338858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 WALLACE AVE",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427541479",
            "telephone_number": "270-259-8888",
            "fax_number": "270-259-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 WALLACE AVE",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427542404",
            "telephone_number": "270-259-8888",
            "fax_number": "270-259-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CARI",
        "middle_name": "BETH",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-06",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3008167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100299030",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARI",
            "last_name": "GLUTTING",
            "middle_name": "BETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Leitchfield, KY

Sources for this page

Verify at the official NPI Registry.