Individual provider Active NPI

Katheryne Anne Barron, N.P.

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1376884759
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
CNP-03012 Issued in NM
Practice address
4705 Montgomery Blvd NE
LMG Gastroenterology Clinic 102
Albuquerque, NM 87109
Phone
(505) 727-7833
Fax
(505) 727-6944
NPI assigned
Mar 8, 2013
Last updated
Jan 6, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 17304 TN
Family Nurse Practitioner 363LF0000X CNP-03012 NM Primary

Addresses

Primary practice location

4705 Montgomery Blvd NE
LMG Gastroenterology Clinic 102
Albuquerque, NM 87109

Mailing address

4705 Montgomery Blvd NE
LMG Gastroenterology Clinic 102
Albuquerque, NM 87109
Phone (505) 727-7833

Other identifiers 1

IdentifierTypeStateIssuer
Q000369MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161202000612 NM Practitioner - Nurse Practitioner 1052557956 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Group practices
Ramah Navajo School Board, IncGroup PAC ID 1153332150, 5 clinicians

Practice addresses (Care Compare)

Bia Route 140
Pinehill, NM 87357-0310
Phone (505) 775-3271

PO Box
Pinehill, NM 87357-0310

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17304TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lovelace Health System, LLC CurrentSince Dec 5, 2016 Accepting new patients
Southwest Medical Associates, LLC CurrentSince Apr 10, 2017 Accepting new patients
Lovelace Health System LLC Current Accepting new patients
Southwest Medical Associates, LLC CurrentSince Apr 10, 2017 Accepting new patients
Ramah Navajo School Board, Inc CurrentSince Aug 23, 2022 Accepting new patients
Lovelace Health System LLC CurrentSince Dec 5, 2016 Accepting new patients

Locations

4701 Montgomery Blvd NE
Albuquerque, NM 87109
Phone (505) 727-2000

4705 Montgomery Blvd NE
Ste 101
Albuquerque, NM 87109
Phone (505) 727-6971

4705 Montgomery Blvd NE
Ste 102
Albuquerque, NM 87109
Phone (505) 727-7833

6100 Pan American East Fwy NE
Ste 100
Albuquerque, NM 87109
Phone (505) 727-6200

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

Organizations & group practices 6

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": "1362700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1376884759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 MONTGOMERY BLVD NE",
            "address_2": "LMG GASTROENTEROLOGY CLINIC 102",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87109",
            "telephone_number": "505-727-7833",
            "fax_number": "505-727-6944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 MONTGOMERY BLVD NE",
            "address_2": "LMG GASTROENTEROLOGY CLINIC 102",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87109",
            "telephone_number": "505-727-7833",
            "fax_number": "505-727-6944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRON",
        "first_name": "KATHERYNE",
        "middle_name": "ANNE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-08",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "17304",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP-03012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q000369",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.