Individual provider Active NPI

Molly Alyssa McClintock

  • Family Nurse Practitioner
  • Versailles, KY
National Provider Identifier
1831825876
Registry record updated Jul 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3014868 Issued in KY
Practice address
212 Kroger Way
Versailles, KY 40383-1991
Phone
(859) 873-9010
NPI assigned
Jul 30, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 371251 OH
Registered Nurse 163W00000X 1156395 KY
Family Nurse Practitioner 363LF0000X 3014868 KY Primary

Addresses

Primary practice location

212 Kroger Way
Versailles, KY 40383-1991

Mailing address

2620 Elm Hill Pike
Nashville, TN 37214-3108
Phone (615) 425-4200

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
I20220815003033 KY Practitioner - Nurse Practitioner 8426431040 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
Kiosk Medicine Kentucky LLCGroup PAC ID 6002887510, 169 clinicians

Practice addresses (Care Compare)

212 Kroger Way
Versailles, KY 40383-1991
Phone (859) 297-1072

Merit-based Incentive Payment System (MIPS)

Final score
83.72 of 100Reported as group
Quality
66.02
Promoting interoperability
100
Improvement activities
40
Cost
79.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1156395KYMDRegistered Nurse
371251OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Kiosk Medicine Kentucky LLC Family CurrentSince Aug 31, 2022 Accepting new patients

Locations

3175 Beaumont Centre Cir
Lexington, KY 40513
Phone (859) 219-1842

3039 Breckenridge Ln
Louisville, KY 40220
Phone (502) 451-4555

212 Kroger Way
Versailles, KY 40383
Phone (859) 297-1072

Interoperability endpoints

  • Direct secure messaging: molly.mcclintock@krogerhealth.eclinicaldirectplus.com

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": "1659139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659139200000",
    "number": "1831825876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 ELM HILL PIKE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372143108",
            "telephone_number": "615-425-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 KROGER WAY",
            "city": "VERSAILLES",
            "state": "KY",
            "postal_code": "403831991",
            "telephone_number": "859-873-9010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLINTOCK",
        "first_name": "MOLLY",
        "middle_name": "ALYSSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-30",
        "last_updated": "2022-07-30",
        "certification_date": "2022-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "371251",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1156395",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3014868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Versailles, KY

Sources for this page

Verify at the official NPI Registry.