Active NPI
Kathryn Roumbanis
- Contractor
- Santa Rosa, CA
National Provider Identifier
1467823138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 4900009RN
- Practice address
- 2403 Professional Dr
Suite 102
Santa Rosa, CA 95403-3007 - Phone
- (707) 284-2950
- Fax
- (707) 284-2955
- NPI assigned
- Oct 7, 2015
- Last updated
- Oct 7, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 4900009RN | CA | Primary |
Addresses
Primary practice location
2403 Professional Dr
Suite 102
Santa Rosa, CA 95403-3007
Mailing address
2403 Professional Dr
Suite 1021
Santa Rosa, CA 95403-3007
Phone (707) 284-2950
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 494907000 | Other | CA | MEDI-CAL |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4900009RN | CA | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444176000000",
"number": "1467823138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2403 PROFESSIONAL DR",
"address_2": "SUITE 1021",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954033007",
"telephone_number": "707-284-2950",
"fax_number": "707-284-2955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2403 PROFESSIONAL DR",
"address_2": "SUITE 102",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954033007",
"telephone_number": "707-284-2950",
"fax_number": "707-284-2955"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROUMBANIS",
"first_name": "KATHRYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-07",
"last_updated": "2015-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "CA",
"license": "4900009RN",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "494907000",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.