Individual provider Active NPI

Kaci Rae Medley, APRN

  • Nurse Practitioner
  • Paducah, KY
National Provider Identifier
1821624339
Registry record updated Mar 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1147322 Issued in KY
Practice address
2501 Kentucky Ave
Paducah, KY 42003-3813
Phone
(270) 575-2100
NPI assigned
Mar 16, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1147322 KY Primary

Addresses

Primary practice location

2501 Kentucky Ave
Paducah, KY 42003-3813

Mailing address

423 Dunnigan LN
Benton, KY 42025-6956

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20210319001175 KY Practitioner - Nurse Practitioner 8325455215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1920 Broadway St
Paducah, KY 42001-7106
Phone (270) 442-3647

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1147322KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Nurse Practitioner CurrentSince Apr 1, 2021 Accepting new patients
Baptist Health Medical Group Inc Nurse Practitioner Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince Apr 1, 2021 Accepting new patients

Locations

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

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

1920 Broadway St
Paducah, KY 42001
Phone (270) 442-3647

2501 Kentucky Ave
Paducah, KY 42003
Phone (270) 575-2180

Organizations & group practices 3

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 2

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": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1821624339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 DUNNIGAN LN",
            "city": "BENTON",
            "state": "KY",
            "postal_code": "420256956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 KENTUCKY AVE",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420033813",
            "telephone_number": "270-575-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLEY",
        "first_name": "KACI",
        "middle_name": "RAE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-16",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "1147322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.