NPIMap

Individual provider Active NPI

Nicole A Brink, APRN

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1831638600
Registry record updated Apr 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3011090 Issued in KY
Practice address
100 Mallard Creek Rd Ste 300
Louisville, KY 40207-5136
Phone
(502) 855-6130
NPI assigned
Feb 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2017

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 3011090 KY Primary

Addresses

Primary practice location

100 Mallard Creek Rd Ste 300
Louisville, KY 40207-5136

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Other identifiers 1

IdentifierTypeStateIssuer
7100451640MedicaidKY

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
I20170324001249 KY Practitioner - Nurse Practitioner 6901181411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

100 Mallard Creek Rd
Louisville, KY 40207-5136

2949 Breckenridge LN
Louisville, KY 40220-1408
Phone (502) 891-8300

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3011090KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince Mar 1, 2017 Accepting new patients
Community Medical Associates, Inc. CurrentSince Mar 1, 2017 Accepting new patients
Community Medical Associates, Inc. Family Current Accepting new patients

Locations

12615 Taylorsville Rd
Ste B
Louisville, KY 40299
Phone (502) 261-1565

3101 Poplar Level Rd
Ste 102
Louisville, KY 40213
Phone (502) 636-6012

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

9880 Angies Way
Ste 160
Louisville, KY 40241
Phone (502) 394-6333

2470 Bardstown Rd
#B
Louisville, KY 40205
Phone (502) 459-3991

100 Mallard Creek Rd
Ste 300
Louisville, KY 40207
Phone (502) 855-6125

1321 Herr Ln
Ste 195
Louisville, KY 40222
Phone (502) 423-7911

300 High Point Ct
Ste A
Mount Washington, KY 40047
Phone (502) 538-0297

150 Frankfort Rd
Ste 104A
Shelbyville, KY 40065
Phone (502) 844-2890

438 Adam Shepherd Pkwy
Ste 2
Shepherdsville, KY 40165
Phone (502) 957-6434

Interoperability endpoints

  • Direct secure messaging: nbrink19827@direct.nortonhealthcare.org

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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1487030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493164800000",
    "number": "1831638600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MALLARD CREEK RD STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402075136",
            "telephone_number": "502-855-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINK",
        "first_name": "NICOLE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-14",
        "last_updated": "2017-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3011090",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100451640",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.