Active NPI
Katherine Pearson, DO
- Pediatrics Physician
- Boone, NC
National Provider Identifier
1174888440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2014-00985
- Practice address
- 336 Deerfield Rd
Boone, NC 28607-5008 - Phone
- (828) 262-4100
- NPI assigned
- Jul 11, 2012
- Last updated
- Mar 29, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Pediatrics Physician | 208000000X | 2014-00985 | NC | Primary |
Addresses
Primary practice location
336 Deerfield Rd
Boone, NC 28607-5008
Mailing address
632 Belmonte Park N
Dayton, OH 45405-4717
Other practice location 1
1 Childrens Plz
Dayton, OH 45404-1898
Phone (937) 641-3000
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
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014-00985 | NC | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blue Ridge Pediatric & Adolescent Medicine, Inc | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- katherinepearson@brpami.allscriptsdirect.net
- kpearson@brpedsadolmed.trimed.direct-ci.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatrics Physician
- Boone, NC
- NPI 1114038163
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616976000000",
"number": "1174888440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "632 BELMONTE PARK N",
"city": "DAYTON",
"state": "OH",
"postal_code": "454054717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "336 DEERFIELD RD",
"city": "BOONE",
"state": "NC",
"postal_code": "286075008",
"telephone_number": "828-262-4100"
}
],
"practiceLocations": [
{
"address_1": "1 Childrens Plz",
"address_purpose": "LOCATION",
"city": "Dayton",
"state": "OH",
"postal_code": "454041898",
"country_code": "US",
"telephone_number": "937-641-3000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PEARSON",
"first_name": "KATHERINE",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-11",
"last_updated": "2021-03-29",
"certification_date": "2021-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "2014-00985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boone, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.