JACKIE STETHEM
NPI 1740848324
Nurse Practitioner - Psychiatric/Mental Health in Lexington, KY

Q: What is Jackie Stethem's NPI number?

The NPI number for Jackie Stethem is 1740848324. It was assigned to this individual provider in the NPPES registry on May 30, 2019.

Q: What is Jackie Stethem's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Jackie Stethem was last updated on October 9, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 30, 2019PECOS EnrolledAccepts Medicare Assignment

3050 RIO DOSA DR, LEXINGTON, KY 40509(859) 269-2325 Get Directions Write a Review

NPPES record last updated: October 9, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Oct 9, 2019, May 30, 2019 (2 updates tracked since 2019).

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About Jackie Stethem NPPES

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

JACKIE STETHEM (NPI 1740848324) is an individual psychiatric/mental health provider in Lexington, Kentucky, licensed in Kentucky (3013689) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2019).

NPPES Registry Identity

NPI1740848324

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameJACKIE STETHEM

Location Address3050 RIO DOSA DRLexington, KY 40509-1540

Mailing Address3050 Rio Dosa DrLexington, KY 40509-1540 · (859) 269-2325

Phone(859) 269-2325

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateMay 30, 2019

Last NPPES UpdateOctober 9, 20192 updates tracked since enumeration

✔ NPI 1740848324 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in KY · 3013689

3050 RIO DOSA DR, Lexington, KY 40509

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jackie Stethem is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2062844905

PECOS Enrollment IDI20191115000215

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40509 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELANIE EHR LCSW

Social Worker (Clinical)