Individual provider Active NPI

Kaitlyn Mary Nettleton

  • Family Nurse Practitioner
  • Mason City, IA
National Provider Identifier
1417633033
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A174962 Issued in IA
Practice address
250 S Crescent Dr
Mason City, IA 50401-2926
Phone
(641) 494-5200
NPI assigned
Jun 27, 2023
Last updated
Jul 10, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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 A174962 IA Primary

Addresses

Primary practice location

250 S Crescent Dr
Mason City, IA 50401-2926

Mailing address

428 4TH St SE
Mason City, IA 50401-4002
Phone (641) 430-7300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address heartcenternurse@mcclinic.direct-ci.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20230720000310 IA Practitioner - Nurse Practitioner 3072973296 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Iowa Mercy ClinicsGroup PAC ID 7810809076, 304 clinicians

Practice addresses (Care Compare)

1000 4TH St SW
Mason City, IA 50401-2800

1421 4TH St SW
Mercyone North Iowa Dermatology Care
Mason City, IA 50401-2736
Phone (641) 428-2080

1720 Central Ave E
Franklin General Hospital
Hampton, IA 50441-1867
Phone (641) 456-5000

250 S Crescent Dr
Mason City, IA 50401-2926

635 E US Hwy 9
Mercyone Forest City Family Medicine
Forest City, IA 50436-1028
Phone (641) 585-2904

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.55 of 100Reported as group
Quality
73.89
Promoting interoperability
93
Improvement activities
40
Cost
70.44

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mason City Clinic PC CurrentSince Jul 10, 2023 Accepting new patients
North Iowa Mercy Clinics Current Accepting new patients
North Iowa Mercy Clinics Current Accepting new patients
North Iowa Mercy Clinics Current Accepting new patients
North Iowa Mercy Clinics CurrentSince Jul 10, 2023 Accepting new patients
North Iowa Mercy Clinics CurrentSince Jul 10, 2023 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
North Iowa Mercy Clinics Past Accepting new patients

Locations

1000 4th St SW
Mason City, IA 50401
Phone (641) 424-6704

250 S Crescent Dr
Mason City, IA 50401
Phone (541) 422-6588

250 S Crescent Dr
Ste 200
Mason City, IA 50401
Phone (641) 494-5300

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1417633033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 4TH ST SE",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504014002",
            "telephone_number": "641-430-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S CRESCENT DR",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504012926",
            "telephone_number": "641-494-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NETTLETON",
        "first_name": "KAITLYN",
        "middle_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A174962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "heartcenternurse@mcclinic.direct-ci.net",
            "affiliation": "N",
            "endpointDescription": "Mason City Clinic Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "250 S Crescent Dr",
            "city": "Mason City",
            "state": "IA",
            "country_code": "US",
            "postal_code": "504012926",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mason City, IA

Sources for this page

Verify at the official NPI Registry.