Kathryn Ann Waldo, CPNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP3157 Issued in AZ

Practice address

4915 E Baseline Rd Ste 119
Gilbert, AZ 85234-2969

Phone

(480) 832-0480

Fax

(480) 832-0490

NPI assigned

Sep 29, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FDGBAA
• FHIR API: https://api.platform.athenahealth.com/3484/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/EJADDD/Endpoint/EJADDD

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.

• All-Star Pediatrics, PLLC

  • Pediatrics Physician
  • Gilbert, AZ
  • NPI 1073801056
  NPD (past)
• Desert Shores Pediatrics

  • Pediatrics Physician
  • Gilbert, AZ
  • NPI 1124386487
  NPD (past)

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1063662914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 E BASELINE RD STE 119",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342969",
            "telephone_number": "480-832-0480",
            "fax_number": "480-832-0490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 E BASELINE RD STE 119",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342969",
            "telephone_number": "480-832-0480",
            "fax_number": "480-832-0490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDO",
        "first_name": "KATHRYN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-29",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "AP3157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "797740",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores Inc
• Wal-Mart Stores, Inc.
• Wal-Mart Stores, Inc.
• Renee Lee Walden-Shea, M.ED
• Kelsey Walden, COTA
• Mark Waldrop II, LPC
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Walgreen Co

• Nurse Practitioner in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.