Active NPI
Mary Kate Hodor
- Neonatal Intensive Care Registered Nurse
- Dallas, GA
National Provider Identifier
1063299154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Intensive Care Registered Nurse
- License
- RN278905
- Practice address
- 152 Adair CT
Dallas, GA 30157-3826 - Phone
- (518) 649-3742
- NPI assigned
- Sep 12, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Intensive Care Registered Nurse | 163WN0002X | RN278905 | GA | Primary |
Addresses
Primary practice location
152 Adair CT
Dallas, GA 30157-3826
Mailing address
152 Adair CT
Dallas, GA 30157-3826
Phone (518) 649-3742
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN278905 | GA | MD | Neonatal Intensive Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694476800000",
"number": "1063299154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 ADAIR CT",
"city": "DALLAS",
"state": "GA",
"postal_code": "301573826",
"telephone_number": "518-649-3742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "152 ADAIR CT",
"city": "DALLAS",
"state": "GA",
"postal_code": "301573826",
"telephone_number": "518-649-3742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HODOR",
"first_name": "MARY KATE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-12",
"last_updated": "2023-09-12",
"certification_date": "2023-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "163WN0002X",
"taxonomy_group": "",
"desc": "Registered Nurse, Neonatal Intensive Care",
"state": "GA",
"license": "RN278905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.