NPIMap

Individual provider Active NPI

Kathryn Storck, MD

  • Obstetrics & Gynecology Physician
  • Shiprock, NM
National Provider Identifier
1063709517
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
9373032-1205 Issued in UT
Practice address
US Hwy 491 North
Shiprock, NM 87420
Phone
(505) 368-6001
Fax
(505) 368-7011
NPI assigned
Jul 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X DR.0059001 CO
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X 9373032-1205 UT Primary

Addresses

Primary practice location

US Hwy 491 North
Shiprock, NM 87420

Mailing address

PO Box 160
Shiprock, NM 87420
Phone (505) 368-6001

Other practice location 1

46 Suttle St
Durango, CO 81303-7947
Phone (303) 813-7642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150804003952 UT Practitioner - Obstetrics/Gynecology 8325299696 Reassigns benefits to 1 organization
I20171004001769 TX Practitioner - Obstetrics/Gynecology 8325299696 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Temple University School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DHHS PHS Naihs Shiprock HospitalGroup PAC ID 0749193837, 148 clinicians

Practice addresses (Care Compare)

Highway 491
Shiprock, NM 87420-0160
Phone 50536860016401

P O Box
160 Attn Business Office
Shiprock, NM 87420-0160

PO Box
Suite 160
Shiprock, NM 87420-0160

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.26 of 100Reported as group
Quality
74.27
Improvement activities
40
Cost
78.06

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DR.0059001COMDObstetrics & Gynecology Physician
9373032-1205UTMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Sep 5, 2017 Accepting new patients
University of Utah Adult Services Obstetrics & Gynecology CurrentSince Jul 1, 2015 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince Sep 5, 2017 Accepting new patients
University of Utah Adult Services CurrentSince Jul 1, 2015 Accepting new patients
University of Utah Adult Services Current Accepting new patients

Locations

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1063709517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "87420",
            "telephone_number": "505-368-6001",
            "fax_number": "505-368-7011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "US HWY 491 NORTH",
            "city": "SHIPROCK",
            "state": "NM",
            "postal_code": "87420",
            "telephone_number": "505-368-6001",
            "fax_number": "505-368-7011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46 Suttle St",
            "address_purpose": "LOCATION",
            "city": "Durango",
            "state": "CO",
            "postal_code": "813037947",
            "country_code": "US",
            "telephone_number": "303-813-7642",
            "fax_number": "303-801-1390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STORCK",
        "first_name": "KATHRYN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CO",
            "license": "DR.0059001",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "9373032-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shiprock, NM

Sources for this page

Verify at the official NPI Registry.