Individual provider Active NPI

Kathryn Ann Dejonge, LPN

  • Licensed Practical Nurse
  • Phelps, NY
National Provider Identifier
1326969304
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
34704301 Issued in NY
Practice address
33 Jay St
Phelps, NY 14532-1016
Phone
(585) 269-4324
NPI assigned
Jul 23, 2026
Last updated
Jul 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 34704301 NY Primary

Addresses

Primary practice location

33 Jay St
Phelps, NY 14532-1016

Mailing address

33 Jay St
Phelps, NY 14532-1016
Phone (585) 269-4324

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1784764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1326969304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 JAY ST",
            "city": "PHELPS",
            "state": "NY",
            "postal_code": "145321016",
            "telephone_number": "585-269-4324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 JAY ST",
            "city": "PHELPS",
            "state": "NY",
            "postal_code": "145321016",
            "telephone_number": "585-269-4324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEJONGE",
        "first_name": "KATHRYN",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-23",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "34704301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phelps, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; 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.