Individual provider Active NPI

Chicqutar Symonette, APRN

  • Family Nurse Practitioner
  • Jeffersonville, IN
National Provider Identifier
1861263477
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71015232A Issued in IN
Practice address
1027 Jeffersonville Commons Dr
Jeffersonville, IN 47130-8395
Phone
(812) 288-0011
NPI assigned
Jan 11, 2024
Last updated
May 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71015232A IN Primary
Family Nurse Practitioner 363LF0000X 4008153 KY

Addresses

Primary practice location

1027 Jeffersonville Commons Dr
Jeffersonville, IN 47130-8395

Mailing address

3004 Sherman Dr
Jeffersonville, IN 47130-5928
Phone (502) 797-5134

Other practice location 1

3004 Sherman Dr
Jeffersonville, IN 47130-5928
Phone (502) 797-5134

Other practice location 2

3039 Breckenridge Ln
Louisville, KY 40220-2101
Phone (502) 451-4555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240515001425 IN Practitioner - Nurse Practitioner 9638510118 Reassigns benefits to 1 organization
I20240611000641 KY Practitioner - Nurse Practitioner 9638510118 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Little Clinic of in LLCGroup PAC ID 7719118447, 66 clinicians
Kiosk Medicine Kentucky LLCGroup PAC ID 6002887510, 169 clinicians

Practice addresses (Care Compare)

1027 Jeffersonville Commons Dr
Jeffersonville, IN 47130-8395
Phone (812) 288-0011

3039 Breckenridge LN
Louisville, KY 40220-2101
Phone (502) 451-4555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kiosk Medicine Kentucky LLC Family CurrentSince Apr 28, 2024 Accepting new patients
Little Clinic of in LLC Family CurrentSince May 9, 2024 Accepting new patients

Locations

815 Highlander Point Dr
Floyds Knobs, IN 47119
Phone (812) 923-7146

1027 Jeffersonville Commons Dr
Jeffersonvlle, IN 47130
Phone (812) 288-0011

1541 E Tipton St
Seymour, IN 47274
Phone (812) 522-4401

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

9080 Taylorsville Rd
Louisville, KY 40299
Phone (502) 491-8805

Interoperability endpoints

  • Direct secure messaging: chicqutar.symonette@krogerhealth.eclinicaldirectplus.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1861263477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 SHERMAN DR",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471305928",
            "telephone_number": "502-797-5134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 JEFFERSONVILLE COMMONS DR",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471308395",
            "telephone_number": "812-288-0011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3004 Sherman Dr",
            "address_purpose": "LOCATION",
            "city": "Jeffersonville",
            "state": "IN",
            "postal_code": "471305928",
            "country_code": "US",
            "telephone_number": "502-797-5134",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3039 Breckenridge Ln",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402202101",
            "country_code": "US",
            "telephone_number": "502-451-4555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SYMONETTE",
        "first_name": "CHICQUTAR",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-11",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71015232A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4008153",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

Verify at the official NPI Registry.