Individual provider Active NPI

Kathleen Andrews

  • Psychiatric/Mental Health Nurse Practitioner
  • Roseville, CA
National Provider Identifier
1285197350
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP95011476 Issued in CA
Practice address
508 Gibson Dr
Roseville, CA 95678-5794
Phone
(916) 865-3670
NPI assigned
Apr 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP95011476 CA Primary

Addresses

Primary practice location

508 Gibson Dr
Roseville, CA 95678-5794

Mailing address

508 Gibson Dr
Roseville, CA 95678-5794
Phone (916) 865-3670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20201105000533 CA Practitioner - Nurse Practitioner 3173933017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Zeam Medical Group IncGroup PAC ID 2466858667, 10 clinicians

Practice addresses (Care Compare)

508 Gibson Dr
Suite 150
Roseville, CA 95678-5796
Phone (916) 865-3670

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95011476CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Zeam Medical Group Inc CurrentSince Aug 1, 2021 Accepting new patients

Locations

508 Gibson Dr
Ste 150
Roseville, CA 95678
Phone (916) 608-0714

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1285197350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 GIBSON DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956785794",
            "telephone_number": "916-865-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 GIBSON DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956785794",
            "telephone_number": "916-865-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-07",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95011476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.