Heather Breann Fenwick

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4034545 Issued in KY

Practice address

106 Winston Way
Campbellsville, KY 42718-4953

Phone

(270) 789-0034

NPI assigned

Jan 27, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Heather Breann Hasty Former name

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

One Cross Health Clinic IncGroup PAC ID 2466790472, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• One Cross Community, Inc.

  • Federally Qualified Health Center (FQHC)
  • Campbellsville, KY
  • NPI 1447710314

  Single Specialty

  Medicare reassignment NPD
• One Cross Health Clinic Inc

  • Rural Health Clinic/Center
  • Campbellsville, KY
  • NPI 1942606454

  Single Specialty

  Care Compare group NPD (past)
• One Cross Community, Inc.

  • Federally Qualified Health Center (FQHC)
  • Lebanon, KY
  • NPI 1215404082

  Single Specialty

  NPD

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

{
    "created_epoch": "1737936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1992518823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 CISSELLVILLE RD",
            "city": "SPRINGFIELD",
            "state": "KY",
            "postal_code": "400698301",
            "telephone_number": "859-475-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 WINSTON WAY",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427184953",
            "telephone_number": "270-789-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENWICK",
        "first_name": "HEATHER",
        "middle_name": "BREANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-27",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "4034545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "HASTY",
            "middle_name": "BREANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Marie Featherstone
• Tammy Feese
• Feltner Foot and Ankle
• Matthew Ryan Feltner, D.P.M.
• William D. Feltner, D.O.
• Ariel Ferrie
• Jason Eugene Fikter, P.T.
• Jamie Flatt, PTA
• Ginger Ford
• Jeanetta Ford, MS, LAT, ATC

• Psychiatric/Mental Health Nurse Practitioner in Campbellsville, KY
• Providers in Campbellsville, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.