KIOSK MEDICINE KENTUCKY LLC
NPI 1205885035
Nurse Practitioner - Family in Louisville, KY

Active since May 09, 2006CLIA 18D1015023 · Waiver
3039 BRECKENRIDGE LN, LOUISVILLE, KY 40220(502) 451-4555(502) 451-0884 Get Directions Write a Review

NPPES record last updated: October 21, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 12, 2025, Dec 12, 2024, Jun 21, 2019 and 2 more (5 updates tracked since 2016).

About Kiosk Medicine Kentucky Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIOSK MEDICINE KENTUCKY LLC (NPI 1205885035) is a healthcare organization registered as a family in Louisville, Kentucky and active in the NPI registry since May 2006. The organization holds a CLIA Waiver certificate valid through July 21, 2027 and lists Thomas Shelly, Vp & General Manager, as its authorized official.

NPPES Registry Identity

NPI1205885035
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameKIOSK MEDICINE KENTUCKY LLC
Location Address3039 BRECKENRIDGE LNLouisville, KY 40220-2101
Mailing AddressPo Box 932958Cleveland, OH 44193-0028 · (615) 425-4200 · Fax (615) 425-4201
Fax(502) 451-0884
Organization SubpartNo
Authorized OfficialThomas ShellyVp & General Manager · (615) 425-4200
Enumeration DateMay 9, 2006
Last NPPES UpdateOctober 21, 20255 updates tracked since enumeration
NPPES CertifiedOctober 21, 2025
✔ NPI 1205885035 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Also ListedPhysician AssistantTaxonomy 363A00000X
3039 BRECKENRIDGE LN, Louisville, KY 40220

Other Identifiers 1

Medicaid7100276100KY

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kiosk Medicine Kentucky Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

485

Medicare enrollment records show 485 clinicians reassign Medicare billing to Kiosk Medicine Kentucky LLC, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 130 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 2

Nurse Practitioner484
Family Practice1

Nearest to this location (20)

See all 485
Nurse Practitioner
NPI 1235745134
3039 BRECKENRIDGE LN
Louisville, KY 40220
(502) 451-4555
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1225812209
3039 BRECKENRIDGE LN
Louisville, KY 40220
(502) 451-4555
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1225564479
3039 BRECKENRIDGE LN
Louisville, KY 40220
(502) 451-4555
✔ PECOSSame address
Nurse Practitioner
NPI 1720621311
3039 BRECKENRIDGE LN
Louisville, KY 40220
(812) 941-3080
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1821361221
3039 BRECKENRIDGE LN
Louisville, KY 40220
(502) 451-4555
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1437739166
4117 BROWNS LN
Louisville, KY 40220
(502) 364-2770
✔ PECOS✔ Accepts Medicare0.3 mi
Nurse Practitioner
NPI 1316551526
2949 BRECKENRIDGE LN
Louisville, KY 40220
(502) 446-5555
✔ PECOS✔ Accepts Medicare0.3 mi
Nurse Practitioner
NPI 1982299038
3703 TAYLORSVILLE RD STE 120
Louisville, KY 40220
(502) 451-7720
✔ PECOS1.0 mi
Nurse Practitioner
NPI 1689332363
3920 DUTCHMANS LN STE 309
Louisville, KY 40207
(502) 588-4740
✔ PECOS✔ Accepts Medicare1.1 mi
Nurse Practitioner
NPI 1114571254
3920 DUTCHMANS LN STE 300
Louisville, KY 40207
(502) 895-8970
✔ PECOS✔ Accepts Medicare1.1 mi
Nurse Practitioner
NPI 1609185628
3920 DUTCHMANS LN STE 315
Louisville, KY 40207
(502) 749-7909
✔ PECOS✔ Accepts Medicare1.1 mi
Nurse Practitioner
NPI 1215654785
3920 DUTCHMANS LN STE 309
Louisville, KY 40207
(502) 588-4740
✔ PECOS✔ Accepts Medicare1.1 mi
Nurse Practitioner
NPI 1548859523
3999 DUTCHMANS LANE MEDICAL PLAZA 1 SUITE 3C
Louisville, KY 40207
(502) 899-6842
✔ PECOS✔ Accepts Medicare1.2 mi
Nurse Practitioner
NPI 1568013696
3999 DUTCHMANS LN STE 3C
Louisville, KY 40207
(502) 899-6842
✔ PECOS✔ Accepts Medicare1.2 mi
Nurse Practitioner
NPI 1881102739
4001 DUTCHMANS LN
Louisville, KY 40207
(502) 893-1270
✔ PECOS✔ Accepts Medicare1.3 mi
Nurse Practitioner
NPI 1487191938
3991 DUTCHMANS LN STE 405
Louisville, KY 40207
(028) 993-3665
✔ PECOS✔ Accepts Medicare1.3 mi
Nurse Practitioner
NPI 1558977470
4123 DUTCHMANS LN STE 606
Louisville, KY 40207
(502) 896-2500
✔ PECOS1.3 mi
Nurse Practitioner
NPI 1952064289
4123 DUTCHMANS LN STE 606
Louisville, KY 40207
(502) 899-6900
✔ PECOS1.3 mi
Nurse Practitioner
NPI 1376050518
3240 SILVER SPRINGS DR UNIT 29
Louisville, KY 40220
(502) 777-0870
✔ PECOS✔ Accepts Medicare1.5 mi
Nurse Practitioner
NPI 1033657903
3900 KRESGE WAY
Louisville, KY 40207
(502) 259-4470
✔ PECOS✔ Accepts Medicare1.6 mi
See all 485 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 18D1015023

Kiosk Medicine Kentucky, LLC · Louisville, KY
Active · expires Jul 21, 2027
CLIA Number18D1015023
Laboratory TypeOther
Certificate Effective DateJuly 22, 2025
Certificate Expiration DateJuly 21, 2027
Laboratory DirectorMs. Erin Macy
Laboratory Phone(502) 451-4555
Laboratory LocationKiosk Medicine Kentucky, LLC3039 Breckenridge Lane, Louisville, KY 40220
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kiosk Medicine Kentucky LLC's NPI number?

The NPI number for Kiosk Medicine Kentucky LLC is 1205885035. It was assigned to this organization in the NPPES registry on May 9, 2006.

Where is Kiosk Medicine Kentucky LLC located?

Kiosk Medicine Kentucky LLC is located at 3039 Breckenridge Ln, Louisville, KY 40220. The listed phone number is (502) 451-4555.

What is Kiosk Medicine Kentucky LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kiosk Medicine Kentucky LLC enrolled in Medicare?

Yes. Kiosk Medicine Kentucky LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Kiosk Medicine Kentucky LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 485 clinicians in 2 Medicare specialties reassign their Medicare billing to Kiosk Medicine Kentucky LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (484) and Family Practice (1). Of these, 5 practice at this address and 130 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Kiosk Medicine Kentucky LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 18D1015023) is associated with this NPI, valid through July 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Kiosk Medicine Kentucky LLC accept?

Health plans from Anthem Blue Cross and Blue Shield, MedMutual and UnitedHealthcare list Kiosk Medicine Kentucky LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kiosk Medicine Kentucky LLC was last updated on October 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.