Magnolia Psychiatry
NPI 1255090510 · Psychiatric/Mental Health Nurse Practitioner · Louisville, KY
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Magnolia Psychiatry is a Psychiatric/Mental Health Nurse Practitioner organization in Louisville, KY (NPI 1255090510).
Provider details
- NPI number
- 1255090510
- Entity type
- Organization
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Angel Squire, Owner(615) 813-0726
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 4523 Shady Place CtBowling Green, KY 42104-4423Phone: (937) 285-0414
Registry dates
- Enumerated
- 2021-12-14
- Last updated
- 2022-02-03
- Certified
- 2022-02-03
Frequently asked questions
- What is Magnolia Psychiatry's NPI number?
- Magnolia Psychiatry's National Provider Identifier (NPI) is 1255090510, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Magnolia Psychiatry?
- Magnolia Psychiatry is classified in the NPPES registry as Psychiatric/Mental Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Magnolia Psychiatry located?
- Magnolia Psychiatry's practice location on file with NPPES is 312 S 4th St Ste 700, Louisville, KY 40202-3046.
- What is Magnolia Psychiatry's phone number?
- The practice phone number listed in the NPPES registry for Magnolia Psychiatry is (615) 813-0726.
- Does Magnolia Psychiatry accept Medicare?
- Magnolia Psychiatry is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Magnolia Psychiatry?
- The authorized official listed on Magnolia Psychiatry's NPPES record is Angel Squire, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Magnolia Psychiatry's NPI active?
- Yes — Magnolia Psychiatry's NPI (1255090510) is active in the NPPES registry as of the last update on 2022-02-03.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.