Individual provider Active NPI

Kathy Ann Loeffler, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Walsenburg, CO
National Provider Identifier
1407862386
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
125142 Issued in CO
Practice address
129 Kansas Ave
Walsenburg, CO 81089-1818
Phone
(719) 738-2718
Fax
(719) 738-2732
NPI assigned
Jul 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 125142 CO Primary

Addresses

Primary practice location

129 Kansas Ave
Walsenburg, CO 81089-1818

Mailing address

23500 US Highway 160
Walsenburg, CO 81089-9524
Phone (719) 738-5144

Other identifiers 1

IdentifierTypeStateIssuer
36238201MedicaidCO

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
125142COMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407862386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23500 US HIGHWAY 160",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810899524",
            "telephone_number": "719-738-5144",
            "fax_number": "719-738-5138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 KANSAS AVE",
            "city": "WALSENBURG",
            "state": "CO",
            "postal_code": "810891818",
            "telephone_number": "719-738-2718",
            "fax_number": "719-738-2732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEFFLER",
        "first_name": "KATHY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "125142",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36238201",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walsenburg, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.