Kathleen Gonzales, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP1844 Issued in AZ

Practice address

613 Bisbee Rd
Bisbee, AZ 85603-1305

Phone

(520) 432-7287

NPI assigned

Sep 22, 2005

Last updated

Jun 12, 2013By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

San Carlos Apache Healthcare CorporationGroup PAC ID 0648580597, 147 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• San Carlos Apache Healthcare Corporation Hospital, Peridot, AZ, CCN 031320

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075

  TX

  Medicare reassignment Care Compare group NPD
• San Carlos Apache Healthcare Corporation

  dba Clarence Wesley Health Center

  • Clinic/Center
  • Bylas, AZ
  • NPI 1417330713
  NPD
• Bisbee Hospital Association

  dba Copper Queen Medical Associates Palominas

  • Rural Health Clinic/Center
  • Hereford, AZ
  • NPI 1225438104
  NPD (past)
• Bisbee Hospital Association

  dba Copper Queen Medical Associates Bisbee

  • Clinic/Center
  • Bisbee, AZ
  • NPI 1568471696
  NPD (past)
• Bisbee Hospital Association

  dba Copper Queen Community Hospital

  • Critical Access Hospital
  • Douglas, AZ
  • NPI 1720536915
  NPD (past)
• Bisbee Hospital Association

  dba Copper Queen Medical Associates-Douglas

  • Clinic/Center
  • Douglas, AZ
  • NPI 1790182871
  NPD (past)
• Bisbee Hospital Association

  dba Copper Queen Community Hospital Tombstone RHC

  • Clinic/Center
  • Tombstone, AZ
  • NPI 1841964624
  NPD (past)
• Bisbee Hospital Association Dba CQCH

  • Rural Acute Care Hospital
  • Bisbee, AZ
  • NPI 1265695415
  NPD (past)
• Copper Queen Medical Associates Douglas

  • Clinic/Center
  • Douglas, AZ
  • NPI 1942217088
  NPD (past)

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

• San Carlos Apache Healthcare Corporation

  • Critical Access Hospital Clinic/Center
  • Peridot, AZ
  • NPI 1265813075
  Care Compare affiliation
• San Carlos Apache Healthcare Corporation

  dba Clarence Wesley Health Center

  • Clinic/Center
  • Bylas, AZ
  • NPI 1417330713

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1487640736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 BISBEE RD",
            "city": "BISBEE",
            "state": "AZ",
            "postal_code": "856031305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 BISBEE RD",
            "city": "BISBEE",
            "state": "AZ",
            "postal_code": "856031305",
            "telephone_number": "520-432-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "KATHLEEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "RN083567",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP1844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "824062",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer E. Druckman, LCSW
• Jessica Lee Fontes, MD
• Frances Jones Dba Oxicheck NW
• Mirna Lorena Franco, PMHNP
• Denice Maylene Gaddie, ACUPUNCTURIST
• Joseph John Graca, PH.D.
• Bianca Faith Gray, D.O.
• Kathy Griesemer, PA-C
• Linda Thresher Grimes, SLP
• Floyd Randel Gummersall, RN

• Family Nurse Practitioner in Bisbee, AZ
• Providers in Bisbee, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.