Active NPI
Kaitlyn Elizabeth Runnels, RN
- Neonatal Nurse Practitioner
- Greeley, CO
National Provider Identifier
1013573997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- 0994847-NP
- Practice address
- 1801 16TH St
Greeley, CO 80631-5199 - Phone
- (970) 810-4121
- NPI assigned
- May 15, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Intensive Care Registered Nurse | 163WN0002X | 1617123 | CO | |
| Neonatal Nurse Practitioner | 363LN0000X | 0994847-NP | CO | Primary |
Addresses
Primary practice location
1801 16TH St
Greeley, CO 80631-5199
Mailing address
1801 16TH St
Greeley, CO 80631-5199
Phone (970) 810-4121
Other practice location 1
12605 E 16th Ave
Aurora, CO 80045-2545
Phone (720) 848-0000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013573997 | Medicaid | CO | |
| 0994847-NP | Other | CO | APN LICENSE |
| 1617123 | Other | CO | RN LICENSE |
Other names 1
- Kaitlyn Elizabeth Merrill
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1617123 | CO | MD | Neonatal Intensive Care Registered Nurse |
| 0994847-NP | CO | MD | Neonatal Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574208000000",
"number": "1013573997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 16TH ST",
"city": "GREELEY",
"state": "CO",
"postal_code": "806315199",
"telephone_number": "970-810-4121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 16TH ST",
"city": "GREELEY",
"state": "CO",
"postal_code": "806315199",
"telephone_number": "970-810-4121"
}
],
"practiceLocations": [
{
"address_1": "12605 E 16th Ave",
"address_purpose": "LOCATION",
"city": "Aurora",
"state": "CO",
"postal_code": "800452545",
"country_code": "US",
"telephone_number": "720-848-0000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RUNNELS",
"first_name": "KAITLYN",
"middle_name": "ELIZABETH",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-15",
"last_updated": "2019-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "163WN0002X",
"taxonomy_group": "",
"desc": "Registered Nurse, Neonatal Intensive Care",
"state": "CO",
"license": "1617123",
"primary": false
},
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "CO",
"license": "0994847-NP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1013573997",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "APN LICENSE",
"identifier": "0994847-NP",
"state": "CO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "1617123",
"state": "CO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KAITLYN",
"last_name": "MERRILL",
"middle_name": "ELIZABETH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.