Individual provider Active NPI

Katrina Kay Suarez, NP-C

  • Primary Care Nurse Practitioner
  • Dayton, OH
National Provider Identifier
1396048229
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN.CNP.023498 Issued in OH
Practice address
4100 W 3Rd St
Dayton, OH 45428-9000
Phone
(379) 972-3734
NPI assigned
Dec 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AG07180272 OH
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X APRN.CNP.023498 OH Primary

Addresses

Primary practice location

4100 W 3Rd St
Dayton, OH 45428-9000

Mailing address

6601 Upper Valley Pike
Urbana, OH 43078-9100
Phone (937) 206-7594

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20181116001093 OH Practitioner - Nurse Practitioner 9739433368 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AG07180272OHMDNurse Practitioner
APRN.CNP.023498OHMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Springfield Urology LLC Single Specialty CurrentSince Oct 15, 2018 Accepting new patients

Locations

1164 E Home Rd
Ste J
Springfield, OH 45503
Phone (937) 342-9260

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1396048229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 UPPER VALLEY PIKE",
            "city": "URBANA",
            "state": "OH",
            "postal_code": "430789100",
            "telephone_number": "937-206-7594",
            "fax_number": "582-998-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W 3RD ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454289000",
            "telephone_number": "379-972-3734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUAREZ",
        "first_name": "KATRINA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-15",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "AG07180272",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "APRN.CNP.023498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.