Active NPI
Kaoru Yamanouchi, CRNP
- Family Nurse Practitioner
- Mobile, AL
National Provider Identifier
1174830012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 1-100606
- Practice address
- 800 Whitley St
Mobile, AL 36610-3318 - Phone
- (251) 456-2276
- Fax
- (251) 456-2205
- NPI assigned
- Sep 13, 2010
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 1-100606 | AL | Primary |
Addresses
Primary practice location
800 Whitley St
Mobile, AL 36610-3318
Mailing address
PO Box 2867
Mobile, AL 36652-2867
Phone (251) 690-8894
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 630000013 | Medicaid | AL | |
| 011846 | Other | AL | MEDICARE GROUP NUMBER |
| 1063439065 | Other | AL | NPI SITE GROUP PAYEE NUMBER |
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 |
|---|---|---|---|
| 1-100606 | AL | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284336000000",
"number": "1174830012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2867",
"city": "MOBILE",
"state": "AL",
"postal_code": "366522867",
"telephone_number": "251-690-8894",
"fax_number": "251-544-2188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 WHITLEY ST",
"city": "MOBILE",
"state": "AL",
"postal_code": "366103318",
"telephone_number": "251-456-2276",
"fax_number": "251-456-2205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YAMANOUCHI",
"first_name": "KAORU",
"credential": "CRNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-13",
"last_updated": "2010-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AL",
"license": "1-100606",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "630000013",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP NUMBER",
"identifier": "011846",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI SITE GROUP PAYEE NUMBER",
"identifier": "1063439065",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Mobile, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.