Individual provider Active NPI

Katlynn Arlene Catherine Scott, RN

  • Registered Nurse
  • Wyoming, MI
National Provider Identifier
1013417567
Registry record updated Feb 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704321008 Issued in MI
Practice address
1853 R W Berends Dr SW
Wyoming, MI 49519-4955
Phone
(616) 534-9300
NPI assigned
Feb 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704321008 MI Primary

Addresses

Primary practice location

1853 R W Berends Dr SW
Wyoming, MI 49519-4955

Mailing address

2456 Pifer Rd
Delton, MI 49046-8552

Other names 1

  • Katlynn Arlene Catherine McCormick Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704321008MIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1519084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519084800000",
    "number": "1013417567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2456 PIFER RD",
            "city": "DELTON",
            "state": "MI",
            "postal_code": "490468552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1853 R W BERENDS DR SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495194955",
            "telephone_number": "616-534-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "KATLYNN",
        "middle_name": "ARLENE CATHERINE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-20",
        "last_updated": "2018-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704321008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATLYNN",
            "last_name": "MCCORMICK",
            "middle_name": "ARLENE CATHERINE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.