NPIMap

Individual provider Active NPI

Kathryn Anne Blair, APRN BC FNP

  • Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1336139336
Registry record updated Nov 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
52207 Issued in CO
Practice address
1625 Medical Center PT Ste 190
Colorado Springs, CO 80907-8721
Phone
(719) 955-6000
Fax
(719) 955-9595
NPI assigned
Oct 21, 2005
Last updated
Nov 11, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 52207 CO Primary

Addresses

Primary practice location

1625 Medical Center PT Ste 190
Colorado Springs, CO 80907-8721

Mailing address

1625 Medical Center PT Ste 190
Colorado Springs, CO 80907-8721
Phone (719) 955-6000

Other identifiers 1

IdentifierTypeStateIssuer
07522041MedicaidCO

Other names 1

  • Kathryn Anne Boyd Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100525000488 CO Practitioner - Nurse Practitioner 3274662556 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Colorado School of Medicine, Denver, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William Storms Allergy Clinic PCGroup PAC ID 7810925781, 12 clinicians

Practice addresses (Care Compare)

1625 Medical Ctr PT
Suite 190
Colorado Springs, CO 80907-8721
Phone (719) 955-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
William Storms Allergy Clinic PC CurrentSince Mar 1, 2010 Accepting new patients
William Storms Allergy Clinic PC CurrentSince Mar 1, 2010 Accepting new patients

Locations

4535 Milestone Ln
Ste Bc
Castle Rock, CO 80104
Phone (720) 547-3151

19245 E Smoky Hill Rd
Unit A
Centennial, CO 80015
Phone (303) 468-8668

830 Tenderfoot Hill Rd
Ste 350
Colorado Springs, CO 80906
Phone (719) 345-1047

6160 Tutt Blvd
Ste 210
Colorado Springs, CO 80923
Phone (719) 345-1047

1625 Medical Center Pt
Ste 190
Colorado Springs, CO 80907
Phone (719) 345-1047

255 Union Blvd
Ste 400
Lakewood, CO 80228
Phone (303) 985-2550

1315 S Pueblo Blvd
Pueblo, CO 81005
Phone (719) 345-1047

5929 Balcones Dr
Ste 200
Austin, TX 78731
Phone (512) 222-5856

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 18

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289433600000",
    "number": "1336139336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 MEDICAL CENTER PT STE 190",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809078721",
            "telephone_number": "719-955-6000",
            "fax_number": "710-955-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 MEDICAL CENTER PT STE 190",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809078721",
            "telephone_number": "719-955-6000",
            "fax_number": "719-955-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "KATHRYN",
        "middle_name": "ANNE",
        "credential": "APRN BC FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2010-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "52207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07522041",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "BOYD",
            "middle_name": "ANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.