Katherine Disston, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

SP028706 Issued in PA

Practice address

5003 Umbria St
Philadelphia, PA 19128-4369

Phone

(215) 483-3444

NPI assigned

Nov 15, 2023

Last updated

Nov 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1700006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1336914894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4626 SPRUCE ST APT 4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191394582",
            "telephone_number": "203-434-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5003 UMBRIA ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191284369",
            "telephone_number": "215-483-3444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISSTON",
        "first_name": "KATHERINE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-15",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "PA",
            "license": "SP028706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Livia Serena Dispenza
• Alexis Dispenziere
• Nathaniel Peter Disser, MD
• Jonathan Dissin, MD
• Disston Chiropractic & Rehabilitation
• Distar Inc.
• Molly Spencer Distefano, LICSW
• Nicholas Distefano, PHARMD
• Distinct Home Health Care, LLC.
• Distinctive Homecare LLC

• Pediatric Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; 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.