Individual provider Active NPI

Katy E Shrode, CRNP

  • Family Nurse Practitioner
  • Madison, AL
National Provider Identifier
1487991568
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-117191 Issued in AL
Practice address
12205 County Line Rd Ste B
Madison, AL 35758-7720
Phone
(256) 325-4365
Fax
(256) 461-0393
NPI assigned
Jan 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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 1-117191 AL Primary

Addresses

Primary practice location

12205 County Line Rd Ste B
Madison, AL 35758-7720

Mailing address

PO Box 2705
Huntsville, AL 35804-2705
Phone (256) 265-5640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20130404000119 AL Practitioner - Nurse Practitioner 1850536319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Alabama School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HH Physician CareGroup PAC ID 4082042940, 108 clinicians

Practice addresses (Care Compare)

8371 Hwy 72 W
Suite 104
Madison, AL 35758-9505
Phone (256) 265-5640

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
HH Physician Care CurrentSince Nov 1, 2020 Accepting new patients
Dawn B Mancuso, MD, LLC Current Accepting new patients
Healthcare Authority of the City of Huntsville Past Accepting new patients

Locations

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

8371 Highway 72 W
Ste 104
Madison, AL 35758
Phone (256) 265-5640

8371 Highway 72 W
Ste 200
Madison, AL 35758
Phone (256) 722-0664

8371 Highway 72 W
Ste 206
Madison, AL 35758
Phone (256) 265-5640

12205 County Line Rd
Ste B
Madison, AL 35758
Phone (256) 325-4365

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1357776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1487991568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2705",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358042705",
            "telephone_number": "256-265-5640",
            "fax_number": "256-265-5647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12205 COUNTY LINE RD STE B",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357587720",
            "telephone_number": "256-325-4365",
            "fax_number": "256-461-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHRODE",
        "first_name": "KATY",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-10",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-117191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.