Individual provider Active NPI

Kathleen Ann Redovan, CRNP

  • Family Nurse Practitioner
  • Sharon, PA
National Provider Identifier
1487813986
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP009832 Issued in PA
Practice address
740 E State St
Sharon, PA 16146-3328
Phone
(724) 983-7200
NPI assigned
Jun 9, 2008
Last updated
Jun 6, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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 SP009832 PA Primary

Addresses

Primary practice location

740 E State St
Sharon, PA 16146-3328

Mailing address

740 E State St
Sharon, PA 16146-3328
Phone (724) 983-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20080729000272 PA Practitioner - Nurse Practitioner 6103990973 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pcma Palliative Division LLC CurrentSince Feb 1, 2022 Accepting new patients
Personal Care Medical Associates LLC CurrentSince Jan 26, 2023 Accepting new patients
Sharon Regional Physicians Services Past Accepting new patients

Locations

110 Fredonia Rd
Greenville, PA 16125
Phone (724) 588-8090

2000 Cliffmine Rd
Ste 500
Pittsburgh, PA 15275
Phone (724) 766-0025

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1487813986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 E STATE ST",
            "city": "SHARON",
            "state": "PA",
            "postal_code": "161463328",
            "telephone_number": "724-983-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 E STATE ST",
            "city": "SHARON",
            "state": "PA",
            "postal_code": "161463328",
            "telephone_number": "724-983-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDOVAN",
        "first_name": "KATHLEEN",
        "middle_name": "ANN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP009832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sharon, PA

Sources for this page

Verify at the official NPI Registry.