KELSEY DOWNTON, APRN
Nurse Practitioner in CRESTVIEW HILLS, Kentucky. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.
What the federal data shows
KELSEY DOWNTON, APRN reported a CMS MIPS final score of 87.5327/100 — above the 83.1 national average — and filed 1,472 Medicare Part D claims in 2023.
- 87.5327/100
- MIPS score · +4 vs avg
- 1K
- Part D claims, 2023
- 99%
- generic prescribing
Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) — no proprietary rating or editorial opinion is applied.
KELSEY DOWNTON, APRN's MIPS score vs every scored U.S. clinician
CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure
88 Top 46% higher than 54% of 477,587 scored providers
Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source CMS Merit-based Incentive Payment System (MIPS) · 2023
What does the federal data show about KELSEY DOWNTON, APRN?
High performer (top quartile)Primary specialty
Medicare Part D claims
MIPS final score
Specialty distribution in Kentucky
How Nurse Practitioner compares to other specialties among Kentucky providers
Nurse Practitioner share within Kentucky
Nurse Practitioner is one of the more visible NUCC categories in Kentucky
Each bar reflects the share of in-state providers whose primary NUCC taxonomy matches the specialty. Long tail of ~690 NUCC codes folded into "Other" to keep the comparison legible.
Medicare quality performance — MIPS
KELSEY DOWNTON, APRN's 2023 MIPS final score plotted against the Nurse Practitioner national average
- MIPS Final Score
- 87.5327/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Nurse Practitioner) — 87.5327/100 vs national avg 83.1
Quality benchmarks
- National MIPS avg 2023 reporting year
- Quality dim CMS Quality category
- Cost dim CMS Cost category
- Specialty volume Nurse Practitioner US NPIs
87.5327/100 MIPS final score — 4.4 pts above the 83.1 national average
Quality, Cost, Promoting Interoperability, and Improvement Activities composite score for the 2023 performance year. Specialty: Nurse Practitioner. Quality dim: 80.5859. Cost dim: 68.0815.
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
KELSEY DOWNTON, APRN appears in the CMS NPPES registry as a Nurse Practitioner provider holding APRN credentials at 320 THOMAS MORE PKWY STE 202, CRESTVIEW HILLS, KY, 41017, with a listed phone of (859) 331-0432. NPI 1962048694 was issued on 11/18/2019. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what DOWNTON most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.
Medicare Part D records for calendar year 2023 show 1,472 prescription claims written by this provider, covering 408 Medicare beneficiaries and totaling roughly $42K in drug spend, split 1% brand-name and 99% generic by claim count, with an opioid prescribing rate of 23.2%. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 87.5327/100 for the 2023 performance year (Quality 80.5859, Cost 68.0815), compared with the national average of 83.1.
Nurse Practitioner is a high-volume specialty nationwide, with 87,227 enrolled providers across 56 states and an average of 1,084 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.
Practice Address
Provider Details
| NPI | 1962048694 |
|---|---|
| Specialty | Nurse Practitioner |
| Credentials | APRN |
| Gender | Female |
| NPI Issued | 11/18/2019 |
Verify this provider's license
PlainDoctor pulls this profile from the CMS NPPES public registry. Confirm KELSEY DOWNTON, APRN's current license status, disciplinary history, and board certifications with the Kentucky Board of Medical Licensure in Kentucky before relying on this page for a clinical or care decision.
How we sourced this profile
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
Reporting: Group practice
Hospital and facility affiliations
Facilities where KELSEY DOWNTON, APRN bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" — a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Brand vs generic prescribing mix · Generic-heavy
1% brand-name claims vs 99% generic, on 1,472 2023 Medicare Part D claims.
The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
Prescribing Breakdown
- 30-Day Fills
- 1,609
- Total Day Supply
- 47,592
- Brand vs Generic
- 1% brand / 99% generic
- Brand Drug Cost
- $10K
- Generic Drug Cost
- $32K
- Opioid Claims
- 342 (23.2% rate)
Patient Demographics
- Average Patient Age
- 65.9 years
- Avg HCC Risk Score
- 1.70
- Gender Split
- 63% female / 38% male
- Age Distribution
- <65: 167, 65-74: 170, 75-84: N/A, 85+: N/A
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
What KELSEY DOWNTON, APRN prescribes most
Top Medicare Part D drugs by claim count, 2023
- Gabapentin
Gabapentin
591 claims
- Hydrocodone-Acetam…
Hydrocodone-Acetaminophen
261 claims
- Tizanidine Hcl 159
Tizanidine Hcl
159 claims
- Pregabalin 81
Pregabalin
81 claims
- Tramadol Hcl 79
Tramadol Hcl
79 claims
- Cyclobenzaprine Hcl 54
Cyclobenzaprine Hcl
54 claims
- Diclofenac Sodium 52
Diclofenac Sodium
52 claims
- Duloxetine Hcl 39
Duloxetine Hcl
39 claims
| Drug | Claims |
|---|---|
| Gabapentin | 591 |
| Hydrocodone-Acetaminophen Hydrocodone/Acetaminophen | 261 |
| Tizanidine Hcl | 159 |
| Pregabalin | 81 |
| Tramadol Hcl | 79 |
| Cyclobenzaprine Hcl | 54 |
| Diclofenac Sodium | 52 |
| Duloxetine Hcl | 39 |
| Meloxicam | 32 |
| Methocarbamol | 29 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Nurse Practitioner Overview
How KELSEY DOWNTON, APRN fits within the Nurse Practitioner landscape nationally.
KELSEY DOWNTON, APRN's 1,472 claims are above the specialty average of 1,084.
Nearby Nurse Practitioner Providers in Kentucky
Other clinicians with the same primary specialty enrolled in Kentucky, drawn from the same CMS NPPES roster as DOWNTON.
Compare Nurse Practitioner nationally: see state-by-state distribution →
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Frequently Asked Questions
What is KELSEY DOWNTON, APRN's specialty? ▼
How much does KELSEY DOWNTON, APRN prescribe under Medicare Part D? ▼
What is KELSEY DOWNTON, APRN's Medicare quality score? ▼
Where is KELSEY DOWNTON, APRN located? ▼
What is KELSEY DOWNTON, APRN's NPI number? ▼
Does KELSEY DOWNTON, APRN prescribe more brand-name or generic drugs? ▼
Does KELSEY DOWNTON, APRN prescribe opioids? ▼
How many Nurse Practitioner providers are there in the US? ▼
What drugs does KELSEY DOWNTON, APRN prescribe most often? ▼
Does KELSEY DOWNTON, APRN accept Medicare? ▼
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Data Sources
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Quality Performance
- CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology