Kathleen Marie Pawlanta, F.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704196460 Issued in MI

Practice address

829 N Center Ave
Suite 210
Gaylord, MI 49735-1595

Phone

(989) 731-7860

Fax

(989) 731-7954

NPI assigned

Jul 17, 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 4

Other names 1

• Kathleen Marie Donnelly Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Munson Healthcare Otsego Memorial HospitalGroup PAC ID 8325942535, 126 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Home Care Home health agency, Traverse City, MI, CCN 237025
• Munson Healthcare Otsego Memorial Hospital Hospital, Gaylord, MI, CCN 230133
• Munson Healthcare Grayling Hospital Hospital, Grayling, MI, CCN 230058
• Munson Medical Center Hospital, Traverse City, MI, CCN 230097

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpawlanta@direct.mhc.net

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.

• Munson Healthcare Otsego Memorial Hospital

  • Rural Health Clinic/Center
  • Gaylord, MI
  • NPI 1164628426
  Medicare reassignment Care Compare group NPD
• Munson Healthcare Otsego Memorial Hospital

  • Plastic Surgery Physician
  • Petoskey, MI
  • NPI 1770374530
  NPD
• Munson Healthcare Otsego Memorial Hospital

  • General Practice Physician
  • Gaylord, MI
  • NPI 1821064643
  NPD
• Petoskey Surgeons, P.C.

  • Surgery Physician
  • Petoskey, MI
  • NPI 1730145574
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Munson Healthcare Grayling

  • Rural Acute Care Hospital
  • Grayling, MI
  • NPI 1083010953
  Care Compare affiliation
• Munson Healthcare Otsego Memorial Hospital

  • General Acute Care Hospital
  • Gaylord, MI
  • NPI 1124028972
  Care Compare affiliation
• Munson Home Care

  • Home Health Agency
  • Traverse City, MI
  • NPI 1326002577
  Care Compare affiliation
• Munson Medical Center

  • General Acute Care Hospital
  • Traverse City, MI
  • NPI 1952307852
  Care Compare affiliation

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1225055833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 N CENTER AVE",
            "address_2": "SUITE 298",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351595",
            "telephone_number": "989-731-7708",
            "fax_number": "989-731-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 N CENTER AVE",
            "address_2": "SUITE 210",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351595",
            "telephone_number": "989-731-7860",
            "fax_number": "989-731-7954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLANTA",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704196460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR PROV ID",
            "identifier": "DC6258",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "381303843",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4600629",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "OF96004",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kathleen.pawlanta@omhmedicalgroup.directbygreenway.com",
            "affiliation": "N",
            "address_1": "829 N Center Ave",
            "address_2": "Suite 210",
            "city": "Gaylord",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497351595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "DONNELLY",
            "middle_name": "MARIE",
            "credential": "F.N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Genevieve L Owens, BEHAVIOR TECHNICIAN
• Samantha Rene' Packard, LMT
• Jeanne Marie Paque
• Tabitha Carolin Pardo, FNP-C
• Patricia Duley MDPC
• Alexis Payne, MD
• Dan Payne, PTA
• Jessica Anne Peacock, CPNP-PC
• Mary Ann Pearall, RD
• Cathryn Gerian Pearl, PA-C

• Family Nurse Practitioner in Gaylord, MI
• Providers in Gaylord, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.