Active NPI
Kathleen M Kissane, RN, CRNP, MSN
- Nurse Practitioner
- Frederick, MD
National Provider Identifier
1477546117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R089131
- Practice address
- 5500 Buckeystown Pike
Frederick, MD 21703-8331 - Phone
- (240) 379-6045
- Fax
- (240) 379-6050
- NPI assigned
- Aug 29, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R089131 | MD | |
| Nurse Practitioner | 363L00000X | R089131 | MD | Primary |
Addresses
Primary practice location
5500 Buckeystown Pike
Frederick, MD 21703-8331
Mailing address
PO Box 277045
Atlanta, GA 30384-7045
Phone (240) 566-3330
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1257868 | Other | AETNA PVN | |
| 2221-0247 | Other | MD | CERT. DIABETES ED. |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305590400000",
"number": "1477546117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 277045",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303847045",
"telephone_number": "240-566-3330",
"fax_number": "240-566-3892"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5500 BUCKEYSTOWN PIKE",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217038331",
"telephone_number": "240-379-6045",
"fax_number": "240-379-6050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISSANE",
"first_name": "KATHLEEN",
"middle_name": "M",
"credential": "RN, CRNP, MSN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-29",
"last_updated": "2011-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MD",
"license": "R089131",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MD",
"license": "R089131",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PVN",
"identifier": "1257868",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERT. DIABETES ED.",
"identifier": "2221-0247",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.