Individual provider Active NPI

Kathryn Grayce Dandrea, CRNA

  • Certified Registered Nurse Anesthetist
  • Cornelius, NC
National Provider Identifier
1396743027
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
43025 Issued in CT
Practice address
19137 Coachmans Trce
Cornelius, NC 28031-9349
Phone
(704) 896-0638
Fax
(704) 896-2917
NPI assigned
Jul 7, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 097233 NC
Certified Registered Nurse Anesthetist 367500000X 43025 CT Primary

Addresses

Primary practice location

19137 Coachmans Trce
Cornelius, NC 28031-9349

Mailing address

19137 Coachmans Trce
Cornelius, NC 28031-9349
Phone (704) 896-0638

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

State licenses

LicenseStateTypeSpecialty
097233NCMDRegistered Nurse
43025NCMDPharmacy Technician
2739SCMDOrthopedic Physical Therapist
43025CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Network Services, LLC Past Accepting new patients
Davidson Anesthesia Consultants, PA Past Accepting new patients
Lenoir Memorial Hospital, Incorporated Past Accepting new patients
Nurse Anesthesia of North Carolina, PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Lenoir Memorial Hospital, Incorporated Nurse Anesthetist, Certified Registered Past Accepting new patients
Coastal Healthcare Resources Inc Registered Nurse Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1396743027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19137 COACHMANS TRCE",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280319349",
            "telephone_number": "704-896-0638",
            "fax_number": "704-896-2917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19137 COACHMANS TRCE",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280319349",
            "telephone_number": "704-896-0638",
            "fax_number": "704-896-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANDREA",
        "first_name": "KATHRYN",
        "middle_name": "GRAYCE",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "097233",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "43025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cornelius, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.