Individual provider Active NPI

Kathryn Genevieve Dempsey, PA

  • Physician Assistant
  • Council Bluffs, IA
National Provider Identifier
1114603867
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
129796 Issued in IA
Practice address
902 S 6TH St
Council Bluffs, IA 51501-6441
Phone
(712) 325-1990
NPI assigned
Jun 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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
Physician Assistant 363A00000X 129796 IA Primary

Addresses

Primary practice location

902 S 6TH St
Council Bluffs, IA 51501-6441

Mailing address

902 S 6TH St
Council Bluffs, IA 51501-6441
Phone (712) 325-1990

Other names 1

  • Kathryn Genevieve Botkin Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250222000260 IA Practitioner - Physician Assistant 8123548047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
All Care Health CenterGroup PAC ID 0547241390, 19 clinicians

Practice addresses (Care Compare)

902 S 6TH St
Council Bluffs, IA 51501-6441

Hospital & facility affiliations

  • Methodist Jennie Edmundson Hospital, Council Bluffs, IA, CCN 160047
  • CHI Health Mercy Council Bluffs Hospital, Council Bluffs, IA, CCN 160028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
129796IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
All Care Health Center CurrentSince Feb 14, 2025 Accepting new patients

Locations

902 S 6th St
Council Bluffs, IA 51501
Phone (712) 256-6583

Interoperability endpoints

  • Direct secure messaging: kbotkin774239@direct.ochin.org
  • FHIR API: https://webprd.ochin.org/prd-fhir/allcarehealthcenter/api/FHIR/R4

Organizations & group practices 1

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 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": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1114603867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 S 6TH ST",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515016441",
            "telephone_number": "712-325-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 S 6TH ST",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515016441",
            "telephone_number": "712-325-1990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMPSEY",
        "first_name": "KATHRYN",
        "middle_name": "GENEVIEVE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "129796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "BOTKIN",
            "middle_name": "GENEVIEVE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Council Bluffs, IA

Sources for this page

Verify at the official NPI Registry.