Active NPI
Kathleen Jane Halverson, CNP
- Family Nurse Practitioner
- Monticello, IN
National Provider Identifier
1376546200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71000299A
- Practice address
- 826 N 6TH St
Monticello, IN 47960-1752 - Phone
- (574) 583-3333
- Fax
- (574) 583-2896
- NPI assigned
- May 24, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71000299A | IN | Primary |
Addresses
Primary practice location
826 N 6TH St
Monticello, IN 47960-1752
Mailing address
826 N 6TH St
Monticello, IN 47960-1752
Phone (574) 583-3333
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000335832 | Other | ANTHEM BLUE CROSS | |
| 1540739 | Other | UNITED MINEWORKERS | |
| 5531418 | Other | AETNA | |
| 500002653 | Other | RAILROAD MEDICARE | |
| 200121420 | Medicaid | IN |
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
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71000299A | IN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316476800000",
"number": "1376546200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "826 N 6TH ST",
"city": "MONTICELLO",
"state": "IN",
"postal_code": "479601752",
"telephone_number": "574-583-3333",
"fax_number": "574-583-2896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "826 N 6TH ST",
"city": "MONTICELLO",
"state": "IN",
"postal_code": "479601752",
"telephone_number": "574-583-3333",
"fax_number": "574-583-2896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALVERSON",
"first_name": "KATHLEEN",
"middle_name": "JANE",
"name_prefix": "Mrs.",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-05-24",
"last_updated": "2011-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71000299A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BLUE CROSS",
"identifier": "000000335832",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED MINEWORKERS",
"identifier": "1540739",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5531418",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "500002653",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200121420",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monticello, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.