Individual provider Active NPI

Jaclyn M Culver, APRN

  • Adult Health Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1891834735
Registry record updated May 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
3003956 Issued in KY
Practice address
3920 S Dupont SQ
Ste C
Louisville, KY 40207-4615
Phone
(812) 282-3899
Fax
(812) 282-4172
NPI assigned
Feb 6, 2007
Last updated
May 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2015

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28193680A IN
Registered Nurse 163W00000X 1098624 KY
Women's Health Nurse Practitioner 363LW0102X 3003956 KY
Adult Health Nurse Practitioner 363LA2200X 3003956 KY Primary

Addresses

Primary practice location

3920 S Dupont SQ
Ste C
Louisville, KY 40207-4615

Mailing address

3920 S Dupont SQ
Ste C
Louisville, KY 40207-4615
Phone (812) 282-3899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28193680AINMDRegistered Nurse
1098624KYMDRegistered Nurse
3003956KYMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431561600000",
    "number": "1891834735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 S DUPONT SQ",
            "address_2": "STE C",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074615",
            "telephone_number": "812-282-3899",
            "fax_number": "812-282-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 S DUPONT SQ",
            "address_2": "STE C",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074615",
            "telephone_number": "812-282-3899",
            "fax_number": "812-282-4172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CULVER",
        "first_name": "JACLYN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2015-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28193680A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1098624",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "KY",
            "license": "3003956",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KY",
            "license": "3003956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.