Individual provider Active NPI

Elizabeth Skinner, APRN

  • Family Nurse Practitioner
  • Kuttawa, KY
National Provider Identifier
1861880221
Registry record updated Apr 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3009151 Issued in KY
Practice address
91 Cedar St
Kuttawa, KY 42055-6287
Phone
(270) 388-7380
NPI assigned
Jan 7, 2015
Last updated
Apr 6, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2018

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 3009151 KY Primary

Addresses

Primary practice location

91 Cedar St
Kuttawa, KY 42055-6287

Mailing address

91 Cedar St
Kuttawa, KY 42055-6287
Phone (270) 388-7380

Other identifiers 1

IdentifierTypeStateIssuer
7100358790MedicaidKY

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
I20150302001670 KY Practitioner - Nurse Practitioner 0244556637 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kuttawa Clinic PLLCGroup PAC ID 9133340466, 2 clinicians

Practice addresses (Care Compare)

91 Cedar St
Kuttawa, KY 42055-6287
Phone (270) 388-7380

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.64 of 100Reported as group
Quality
99.06
Improvement activities
40
Cost
79.86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3009151KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kuttawa Clinic, PLLC Family CurrentSince Oct 17, 2016 Accepting new patients
Fast Pace Kentucky PLLC Family CurrentSince Sep 12, 2016 Accepting new patients
Fast Pace Kentucky, PLLC CurrentSince Sep 12, 2016 Accepting new patients

Locations

1475 Nashville Rd
Franklin, KY 42134
Phone (270) 813-1111

91 Cedar St
Kuttawa, KY 42055
Phone (270) 388-7380

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GACICA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1420588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522972800000",
    "number": "1861880221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 CEDAR ST",
            "city": "KUTTAWA",
            "state": "KY",
            "postal_code": "420556287",
            "telephone_number": "270-388-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "91 CEDAR ST",
            "city": "KUTTAWA",
            "state": "KY",
            "postal_code": "420556287",
            "telephone_number": "270-388-7380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKINNER",
        "first_name": "ELIZABETH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-07",
        "last_updated": "2018-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3009151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100358790",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kuttawa, KY

Sources for this page

Verify at the official NPI Registry.