Individual provider Active NPI

Kaitlyn Cooper Mohlenbrok, NP

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1811778129
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4010937 Issued in KY
Practice address
9905 Shelbyville Rd
Louisville, KY 40223-2907
Phone
(502) 425-5166
NPI assigned
Oct 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-177065 AL
Family Nurse Practitioner 363LF0000X 4010937 KY Primary

Addresses

Primary practice location

9905 Shelbyville Rd
Louisville, KY 40223-2907

Mailing address

9905 Shelbyville Rd
Louisville, KY 40223-2907
Phone (502) 425-5166

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1-177065ALMDRegistered Nurse
4010937KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DRS. Hinkebein, Davis & McCormick, PLLC Family CurrentSince Oct 15, 2023 Accepting new patients

Locations

9905 Shelbyville Rd
Louisville, KY 40223
Phone (502) 425-5166

Organizations & group practices 1

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": "1697068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1811778129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9905 SHELBYVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402232907",
            "telephone_number": "502-425-5166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9905 SHELBYVILLE RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402232907",
            "telephone_number": "502-425-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOHLENBROK",
        "first_name": "KAITLYN",
        "middle_name": "COOPER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-12",
        "last_updated": "2024-07-25",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-177065",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4010937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.