Kendra Sue McClellan, ACNPC-AG
Individual provider Active NPI Gerontology Nurse Practitioner · Lexington, KY
NPI 1861169732 · NPPES record last updated Aug 8, 2022
Key facts
- NPI
- 1861169732
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gerontology Nurse Practitioner 363LG0600X
- License
- 3016493 (KY)
- Practice address
- 1050 Monarch St Ste 300
Lexington, KY 40513-1877 - Phone
- (859) 286-9951
- Fax
- (859) 233-3304
- NPI assigned
- Aug 27, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Baptist Health Medical Group Inc
Practice addresses (Care Compare)
1720 Nicholasville Rd
Suite 601
Lexington, KY 40503-1451
Phone (859) 277-5887
Hospital & facility affiliations
- Baptist Health Lexington
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211020003144 | KY | Practitioner - Nurse Practitioner | 0446648679 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3016493 | KY | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caremed Health Solutions of Kentucky, LLC | Multi-Specialty | Current |
Accepting new patients |
| Davanand Doodnauth,M.D., PSC | Multi-Specialty | Current |
Accepting new patients |
| Baptist Health Medical Group Inc | Multi-Specialty | Current |
Accepting new patients |
| Baptist Health Medical Group Inc | Multi-Specialty | Current |
Accepting new patients |
Locations
1820 Oakview Rd
Ashland, KY 41101
Phone (606) 325-5200
1050 Monarch St
Ste 300
Lexington, KY 40513
Phone (859) 286-9951
1720 Nicholasville Rd
Ste 601
Lexington, KY 40503
Phone (859) 971-4652
3300 Tates Creek Rd
Lexington, KY 40502
Phone (859) 266-2126
1 Saint Joseph Dr
Lexington, KY 40504
Phone (502) 350-5000
620 Parker Rd
Maysville, KY 41056
Phone (606) 564-4085
65 Ramapo Valley Rd
Ste 102B
Mahwah, NJ 07430
Phone (614) 774-7988
300 Tice Blvd
Ste 175
Woodcliff Lake, NJ 07677
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner |
363LG0600X | 3016493 | KY | Yes |
Addresses
Primary practice location
1050 Monarch St Ste 300
Lexington, KY 40513-1877
Mailing address
126 Old Post Rd
Paris, KY 40361-2713
Phone (859) 200-2173
Other practice location 1
620 Parker Rd
Maysville, KY 41056-9620
Phone (731) 394-1145
Other providers in Lexington, KY
- Bridget McClain
- Karen McClain
- Jessica McClanahan
- Kris McClanahan
- Sarah Michelle McClanahan
- Sherry Jaynes McClellan
- Casey Taylor McClelland
- Erie Lynn McClendon
- Kiera Marie McCloskey
- Karen Santos McCloud
All providers in Lexington, KY · Gerontology Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.