Active NPI
Kathleen Merry, ARNP
- Nurse Practitioner
- Waterloo, IA
National Provider Identifier
1306821160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- C-070768
- Practice address
- 905 Franklin St
Waterloo, IA 50703-4407 - Phone
- (319) 272-4300
- NPI assigned
- Dec 14, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | C-070768 | IA | Primary |
Addresses
Primary practice location
905 Franklin St
Waterloo, IA 50703-4407
Mailing address
905 Franklin St
Waterloo, IA 50703-4407
Phone (319) 874-3000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0076372 | Medicaid | IA | |
| 17879 | Other | IA | WELLMARK |
Other names 1
- Kathy Merry
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-070768 | IA | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525046400000",
"number": "1306821160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "905 FRANKLIN ST",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507034407",
"telephone_number": "319-874-3000",
"fax_number": "319-874-3411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 FRANKLIN ST",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507034407",
"telephone_number": "319-272-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRY",
"first_name": "KATHLEEN",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-12-14",
"last_updated": "2018-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IA",
"license": "C-070768",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0076372",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "17879",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KATHY",
"last_name": "MERRY",
"credential": "ARNP",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Waterloo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.