Katherine Bloodworth, MNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209005931 Issued in IL

Practice address

1501 McPherson Ave
Mount Vernon, IL 62864-2831

Phone

(618) 241-1748

NPI assigned

Oct 3, 2006

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Marion Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Marion, IL
  • NPI 1679870513
  NPD (past)
• Midwest Emergency Good Samaritan, Inc

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1629367578
  NPD (past)
• Mount Vernon Emergency Group PC

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1447502141

  Nurse Practitioner

  NPD (past)
• New Century Physicians of Southern Illinois Inc

  • Emergency Medicine Physician
  • Marion, IL
  • NPI 1922007533
  NPD (past)
• Physician Services Corporation of Southern Illinois Inc.

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807
  NPD (past)
• Sterling Emergency Physicians of Illinois, S.C

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1295975837

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227657600000",
    "number": "1154415008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 MCPHERSON AVE",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642831",
            "telephone_number": "618-241-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MCPHERSON AVE",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642831",
            "telephone_number": "618-241-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOODWORTH",
        "first_name": "KATHERINE",
        "credential": "MNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209005931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MED GRP ID",
            "identifier": "CG2264",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE ID",
            "identifier": "P00635208",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nathan Biggerstaff Andrew Biggerstaff, QMHP
• William Alan Bishop
• Eric Lee Black, R.PH
• Clarisa Blakemore, RN
• Helaine Sue Blomenkamp, FNP-C
• Daniel P. Boehmer, LCPC
• Curtis William Boehne, MSW, LCSW
• Olivia Boehnke
• Michele L Boester, PTA
• Brittney Boldt, M.S., CCC-SLP

• All providers in Mount Vernon, IL
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2008; 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.