Individual provider Active NPI

Kathleen Marie Bockhold, MSN, ARNP-BC

  • Adult Health Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1285808626
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
5965 Issued in TN
Practice address
1365 W Brierbrook Rd
Germantown, TN 38138-2208
Phone
(662) 349-9990
Fax
(662) 349-2620
NPI assigned
Apr 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 5965 TN Primary
Nurse Practitioner 363L00000X A810342 MS

Addresses

Primary practice location

1365 W Brierbrook Rd
Germantown, TN 38138-2208

Mailing address

122 Airways PL
Southaven, MS 38671-5872
Phone (662) 349-9990

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)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5965TNMDRadiologic Technologist
A810342MSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Continence Care - TN, LLC Nurse Practitioner Past Accepting new patients

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": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284508800000",
    "number": "1285808626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 AIRWAYS PL",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715872",
            "telephone_number": "662-349-9990",
            "fax_number": "662-349-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1365 W BRIERBROOK RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382208",
            "telephone_number": "662-349-9990",
            "fax_number": "662-349-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCKHOLD",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSN, ARNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2010-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TN",
            "license": "5965",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "A810342",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.