Individual provider Active NPI

Katharine Gilly Li, FNP-C

  • Family Nurse Practitioner
  • Sausalito, CA
National Provider Identifier
1366985988
Registry record updated Feb 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95022284 Issued in CA
Practice address
2 Crecienta Dr
Sausalito, CA 94965-1806
Phone
(504) 952-0111
NPI assigned
Nov 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X RN131730 LA
Family Nurse Practitioner 363LF0000X AP09236 LA
Family Nurse Practitioner 363LF0000X 341656 NY
Family Nurse Practitioner 363LF0000X 95022284 CA Primary

Addresses

Primary practice location

2 Crecienta Dr
Sausalito, CA 94965-1806

Mailing address

2 Crecienta Dr
Sausalito, CA 94965-1806
Phone (504) 952-0111

Other practice location 1

28 Middagh St
Brooklyn, NY 11201-1340
Phone (504) 952-0111

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

LicenseStateTypeSpecialty
RN131730LAMDGeneral Practice Registered Nurse
95022284CAMDFamily Nurse Practitioner
AP09236LAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675382400000",
    "number": "1366985988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CRECIENTA DR",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949651806",
            "telephone_number": "504-952-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CRECIENTA DR",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949651806",
            "telephone_number": "504-952-0111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "28 Middagh St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112011340",
            "country_code": "US",
            "telephone_number": "504-952-0111",
            "fax_number": "646-465-8489",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LI",
        "first_name": "KATHARINE",
        "middle_name": "GILLY",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-30",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "LA",
            "license": "RN131730",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP09236",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "341656",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95022284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sausalito, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.