Individual provider Active NPI

McKenzie Kunnecke

  • Family Nurse Practitioner
  • Cadiz, KY
National Provider Identifier
1881366227
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3016123 Issued in KY
Practice address
214 Main St
Cadiz, KY 42211-9153
Phone
(270) 522-0898
NPI assigned
Oct 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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 3016123 KY Primary

Addresses

Primary practice location

214 Main St
Cadiz, KY 42211-9153

Mailing address

633 Oak Park Blvd
Calvert City, KY 42029-8315
Phone (270) 703-4462

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
I20220923001261 KY Practitioner - Nurse Practitioner 7416332648 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trigg County Hospital, IncGroup PAC ID 5193620805, 33 clinicians

Practice addresses (Care Compare)

214 Main St
Cadiz, KY 42211-9153
Phone (270) 522-0898

254 Main St
Cadiz, KY 42211-9153
Phone (270) 522-3215

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3016123KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Sep 1, 2022 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Sep 1, 2022 Accepting new patients
Trigg County Hospital, Inc CurrentSince Dec 2, 2022 Accepting new patients
Trigg County Hospital, Inc CurrentSince Dec 2, 2022 Accepting new patients

Locations

250 Main St
Ste B
Cadiz, KY 42211

254 Main St
Cadiz, KY 42211
Phone (270) 522-3215

214 Main St
Cadiz, KY 42211
Phone (270) 522-0898

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

2601 Kentucky Ave
Ste 103
Paducah, KY 42003
Phone (270) 415-4860

Organizations & group practices 4

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 1

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": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1881366227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 OAK PARK BLVD",
            "city": "CALVERT CITY",
            "state": "KY",
            "postal_code": "420298315",
            "telephone_number": "270-703-4462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 MAIN ST",
            "city": "CADIZ",
            "state": "KY",
            "postal_code": "422119153",
            "telephone_number": "270-522-0898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUNNECKE",
        "first_name": "MCKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-04",
        "last_updated": "2021-10-04",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3016123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadiz, KY

Sources for this page

Verify at the official NPI Registry.