Individual provider Active NPI

Katherine Lynn Peraud, DO

  • Emergency Medicine Physician
  • Kansas City, MO
National Provider Identifier
1063457430
Registry record updated Oct 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2008002448 Issued in MO
Practice address
4401 Wornall Rd
Kansas City, MO 64111-3220
Phone
(816) 932-2171
NPI assigned
Jun 18, 2006
Last updated
Oct 15, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 2005018539 MO
Emergency Medicine Physician 207P00000X 2008002448 MO Primary

Addresses

Primary practice location

4401 Wornall Rd
Kansas City, MO 64111-3220

Mailing address

PO Box 78009
Saint Louis, MO 63178-8009
Phone (866) 898-7142

Other identifiers 5

IdentifierTypeStateIssuer
200573730CMedicaidKS
200573730AMedicaidKS
200573730DMedicaidKS
200573730BMedicaidKS
40355015OtherBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090610000527 IA Practitioner - Emergency Medicine 5294809661 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Johnson County Emergency Medicine PLCGroup PAC ID 6901231810, 29 clinicians

Practice addresses (Care Compare)

1195 Boyson Rd
Suite 101
Hiawatha, IA 52233-2218
Phone (319) 832-3950

500 E Market St
Iowa City, IA 52245-2633
Phone (319) 339-0300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2005018539MOMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson County Emergency Medicine, PLC Emergency Medicine CurrentSince Jan 1, 2020 Accepting new patients
Linn County Emergency Medicine PC Emergency Medicine Current Accepting new patients
Linn County Emergency Medicine PC Emergency Medicine CurrentSince Jul 1, 2009 Accepting new patients
VA Eastern Kansas Health Care System Emergency Medicine Past Accepting new patients
University Health Physicians Emergency Medicine Past Accepting new patients

Locations

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

1195 Boyson Rd
Ste 101
Hiawatha, IA 52233
Phone (319) 832-3950

500 E Market St
Iowa City, IA 52245
Phone (319) 339-0300

999 35th St
Marion, IA 52302

Organizations & group practices 5

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

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224028800000",
    "number": "1063457430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78009",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631788009",
            "telephone_number": "866-898-7142",
            "fax_number": "616-975-9824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 WORNALL RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113220",
            "telephone_number": "816-932-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERAUD",
        "first_name": "KATHERINE",
        "middle_name": "LYNN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2008-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MO",
            "license": "2005018539",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "2008002448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200573730C",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200573730A",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200573730D",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200573730B",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "40355015",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.