Active NPI
Katrine Andreasen, D.M.D., MS
- Periodontics
- Rockford, IL
National Provider Identifier
1114372422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 019.032049
- Practice address
- 1055 Featherstone Rd
Rockford, IL 61107 - Phone
- (815) 227-5858
- NPI assigned
- Apr 25, 2016
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 019.032049 | IL | Primary |
Addresses
Primary practice location
1055 Featherstone Rd
Rockford, IL 61107
Mailing address
1055 Featherstone Rd
Rockford, IL 61107-5904
Other practice location 1
331 Zorn Pl Apt 11
Louisville, KY 40206-1542
Phone (502) 939-7614
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.032049 | IL | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565740800000",
"number": "1114372422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 FEATHERSTONE RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611075904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 FEATHERSTONE RD",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "61107",
"telephone_number": "815-227-5858"
}
],
"practiceLocations": [
{
"address_1": "331 Zorn Pl Apt 11",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402061542",
"country_code": "US",
"telephone_number": "502-939-7614",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANDREASEN",
"first_name": "KATRINE",
"name_prefix": "Dr.",
"credential": "D.M.D., MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-25",
"last_updated": "2019-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "IL",
"license": "019.032049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.