Individual provider Active NPI

Brianna Flanigan

  • Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1891303319
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3013977 Issued in KY
Practice address
6400 Dutchmans Pkwy Ste 250
Louisville, KY 40205-3354
Phone
(502) 587-9660
Fax
(502) 540-5615
NPI assigned
Jul 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 3013977 KY Primary

Addresses

Primary practice location

6400 Dutchmans Pkwy Ste 250
Louisville, KY 40205-3354

Mailing address

6400 Dutchmans Pkwy Ste 250
Louisville, KY 40205-3354
Phone (502) 587-9660

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
I20200804001326 KY Practitioner - Nurse Practitioner 6406271717 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3013977KYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nephrology Associates of Kentuckiana PSC CurrentSince Jun 30, 2020 Accepting new patients
Commonwealth of Kentucky CurrentSince Jun 24, 2022 Accepting new patients
Commonwealth of Kentucky CurrentSince Jun 24, 2022 Accepting new patients
Commonwealth of Kentucky Past Accepting new patients

Locations

1451 Harrodsburg Rd
Ste D304
Lexington, KY 40504
Phone (859) 317-1673

1800 Bluegrass Ave
Louisville, KY 40215
Phone (502) 361-2301

3 Audubon Plaza Dr
Ste 330
Louisville, KY 40217
Phone (502) 583-1697

6400 Dutchmans Pkwy
Ste 250
Louisville, KY 40205
Phone 5025879660239

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.

NPI Registry JSON

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1891303319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 DUTCHMANS PKWY STE 250",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053354",
            "telephone_number": "502-587-9660",
            "fax_number": "502-540-5615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 DUTCHMANS PKWY STE 250",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402053354",
            "telephone_number": "502-587-9660",
            "fax_number": "502-540-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANIGAN",
        "first_name": "BRIANNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3013977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.