Individual provider Active NPI

Catherine Joaquin

  • Adult Health Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1336252196
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
3007265 Issued in KY
Practice address
3991 Dutchmans LN
Ste. 205
Louisville, KY 40207-4700
Phone
(502) 899-6170
NPI assigned
Aug 16, 2006
Last updated
Jul 25, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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 084616 MO
Adult Health Nurse Practitioner 363LA2200X 3007265 KY Primary

Addresses

Primary practice location

3991 Dutchmans LN
Ste. 205
Louisville, KY 40207-4700

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 272-5100

Other identifiers 2

IdentifierTypeStateIssuer
K032290OtherKYMEDICARE PTAN- NMA PRP
425343605MedicaidMO

Other names 1

  • Catherine Cummins Former name

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Groups LC Past Accepting new patients
Physician Groups LC Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1336252196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-272-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3991 DUTCHMANS LN",
            "address_2": "STE. 205",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074700",
            "telephone_number": "502-899-6170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOAQUIN",
        "first_name": "CATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "084616",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KY",
            "license": "3007265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN- NMA PRP",
            "identifier": "K032290",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "425343605",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CATHERINE",
            "last_name": "CUMMINS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2016; 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.