Kathy Lynn Pregent

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

4710 Lighterwood Way
Valrico, FL 33596-8124

Phone

(813) 504-1565

Fax

(813) 643-6630

NPI assigned

Dec 26, 2010

Last updated

Dec 26, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Miss Kathy Lynn Wells Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1293321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293321600000",
    "number": "1215231766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4710 LIGHTERWOOD WAY",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335968124",
            "telephone_number": "813-504-1565",
            "fax_number": "813-643-6630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4710 LIGHTERWOOD WAY",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335968124",
            "telephone_number": "813-504-1565",
            "fax_number": "813-643-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREGENT",
        "first_name": "KATHY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-26",
        "last_updated": "2010-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "688427096",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "688427098",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHY",
            "last_name": "WELLS",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Specialist in Valrico, FL
• Providers in Valrico, FL by specialty
• Specialist in Florida

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

Verify at the official NPI Registry.