Individual provider Active NPI

Kathy Vannachith

  • Adult Health Nurse Practitioner
  • Durham, NC
National Provider Identifier
1194549907
Registry record updated Nov 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
2023061514 Issued in NC
Practice address
307 Trent Dr
Durham, NC 27710-3038
Phone
(919) 684-4248
NPI assigned
Nov 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 2023061514 NC Primary

Addresses

Primary practice location

307 Trent Dr
Durham, NC 27710-3038

Mailing address

307 Trent Dr
Durham, NC 27710-3038

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

LicenseStateTypeSpecialty
2023061514NCMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1731110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731110400000",
    "number": "1194549907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 TRENT DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277103038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 TRENT DR",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277103038",
            "telephone_number": "919-684-4248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNACHITH",
        "first_name": "KATHY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-09",
        "last_updated": "2024-11-09",
        "certification_date": "2024-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "2023061514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2024; 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.