NPIMap

Individual provider Active NPI

Kathleeen Kae Zambo, CNP

  • Family Nurse Practitioner
  • Eagle Butte, SD
National Provider Identifier
1033183595
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SD- RO17146 Issued in SD
Practice address
24276 Airport Road
Eagle Butte, SD 57625
Phone
(605) 964-7724
Fax
(605) 964-1110
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SD- RO17146 SD Primary

Addresses

Primary practice location

24276 Airport Road
Eagle Butte, SD 57625

Mailing address

39382 128TH St
Bath, SD 57427-5200
Phone (605) 226-0184

Other names 1

  • Mrs. Kathy Kae Zambo Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100810000827 TX Practitioner - Nurse Practitioner 6406980648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eagle Butte Indian Health Service HospitalGroup PAC ID 7517852759, 42 clinicians

Practice addresses (Care Compare)

24276 166TH Airport Rd
Eagle Butte, SD 57625-1022
Phone 60596477240515

PO Box
Suite 1012
Eagle Butte, SD 57625-1012

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SD- RO17146SDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eagle Butte Indian Health Service Hospital CurrentSince Jul 1, 2001 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1033183595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39382 128TH ST",
            "city": "BATH",
            "state": "SD",
            "postal_code": "574275200",
            "telephone_number": "605-226-0184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24276 AIRPORT ROAD",
            "city": "EAGLE BUTTE",
            "state": "SD",
            "postal_code": "57625",
            "telephone_number": "605-964-7724",
            "fax_number": "605-964-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAMBO",
        "first_name": "KATHLEEEN",
        "middle_name": "KAE",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SD",
            "license": "SD- RO17146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "ZAMBO",
            "middle_name": "KAE",
            "prefix": "MRS.",
            "credential": "CNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Eagle Butte, SD

Sources for this page

Verify at the official NPI Registry.