Kortney Jo Koterass

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

344872-01 Issued in NY

Practice address

24B Blue Jay St
Kennedy, NY 14747-9549

Phone

(716) 490-5282

NPI assigned

Mar 13, 2023

Last updated

Mar 13, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1457052813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24B BLUE JAY ST",
            "city": "KENNEDY",
            "state": "NY",
            "postal_code": "147479549",
            "telephone_number": "716-490-5282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24B BLUE JAY ST",
            "city": "KENNEDY",
            "state": "NY",
            "postal_code": "147479549",
            "telephone_number": "716-490-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOTERASS",
        "first_name": "KORTNEY",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "344872-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Jensen
• Kennedy Fire District
• Heidi J Raynor, LMSW

• Licensed Practical Nurse in Kennedy, NY
• Providers in Kennedy, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.