Active NPI
Katarina I Utermark, CNA
- Home Health Agency
- Boones Mill, VA
National Provider Identifier
1093467375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 1401191551
- Practice address
- 75 Blue Hills Dr
Boones Mill, VA 24065-1103 - Phone
- (540) 808-6808
- NPI assigned
- Jan 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 1401191551 | VA | Primary |
Addresses
Primary practice location
75 Blue Hills Dr
Boones Mill, VA 24065-1103
Mailing address
75 Blue Hills Dr
Boones Mill, VA 24065-1103
Phone (540) 808-6808
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1401191551 | Other | VA | CNA STATE REGISTRY |
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 |
|---|---|---|---|
| 1401191551 | VA | MD | Home Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642550400000",
"number": "1093467375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 BLUE HILLS DR",
"city": "BOONES MILL",
"state": "VA",
"postal_code": "240651103",
"telephone_number": "540-808-6808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 BLUE HILLS DR",
"city": "BOONES MILL",
"state": "VA",
"postal_code": "240651103",
"telephone_number": "540-808-6808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UTERMARK",
"first_name": "KATARINA",
"middle_name": "I",
"credential": "CNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-01-19",
"last_updated": "2022-01-19",
"certification_date": "2022-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "VA",
"license": "1401191551",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CNA STATE REGISTRY",
"identifier": "1401191551",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boones Mill, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.