Individual provider Active NPI

Katherine Perko Hollander, AGPCNP-BC

  • Adult Health Nurse Practitioner
  • Berkley, MI
National Provider Identifier
1245858307
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
4704335808 Issued in MI
Practice address
2274 Earlmont Rd
Berkley, MI 48072-1877
Phone
(816) 223-9918
NPI assigned
Jul 6, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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 4704335808 MI Primary

Addresses

Primary practice location

2274 Earlmont Rd
Berkley, MI 48072-1877

Mailing address

2274 Earlmont Rd
Berkley, MI 48072-1877
Phone (816) 223-9918

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230622000542 KS Practitioner - Nurse Practitioner 4385002484 Reassigns benefits to 1 organization
I20241224001618 MI Practitioner - Nurse Practitioner 4385002484 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Oct 21, 2024 Accepting new patients
Signify Health Medical Associates of Kansas LLC CurrentSince Jun 7, 2023 Accepting new patients

Locations

801 E Douglas Ave
Fl 2
Wichita, KS 67202
Phone (316) 330-5353

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1245858307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2274 EARLMONT RD",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721877",
            "telephone_number": "816-223-9918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2274 EARLMONT RD",
            "city": "BERKLEY",
            "state": "MI",
            "postal_code": "480721877",
            "telephone_number": "816-223-9918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLANDER",
        "first_name": "KATHERINE",
        "middle_name": "PERKO",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704335808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkley, MI

Sources for this page

Verify at the official NPI Registry.