Individual provider Active NPI

Kathryn Havens, MSN, FNP-BC

  • Family Nurse Practitioner
  • Scottsdale, AZ
National Provider Identifier
1396380366
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
232607 Issued in AZ
Practice address
10117 N 92ND St Ste 101
Scottsdale, AZ 85258-4555
Phone
(480) 614-5808
NPI assigned
Nov 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 232607 AZ Primary

Addresses

Primary practice location

10117 N 92ND St Ste 101
Scottsdale, AZ 85258-4555

Mailing address

5056 E Gallop Way
Scottsdale, AZ 85254-0020
Phone (978) 239-6123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20241016001755 AZ Order and Referring Only - Nurse Practitioner 7315371671

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
232607AZMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: kathryn.digiammarino.1@8422.direct.athenahealth.com
  • Direct secure messaging: kathryn.digiammarino.2@8422.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1573603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1396380366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5056 E GALLOP WAY",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852540020",
            "telephone_number": "978-239-6123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10117 N 92ND ST STE 101",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584555",
            "telephone_number": "480-614-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVENS",
        "first_name": "KATHRYN",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-13",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "232607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.