Kaitlin Marie Zagami, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1796 Issued in KY

Practice address

3999 Dutchmans LN Ste 6F
Louisville, KY 40207-4724

Phone

(502) 394-5678

Fax

(502) 394-5600

NPI assigned

Apr 5, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kaitlin M Keaveny Former name

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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 and National Provider Directory roles.

• Community Medical Associates, Inc.

  • Multi-Specialty Clinic/Center
  • Louisville, KY
  • NPI 1306983762
  Medicare reassignment
• Community Medical Associates, Inc.

  • Orthopaedic Surgery of the Spine Physician
  • Louisville, KY
  • NPI 1437382074

  Physician Assistant

  NPD
• Community Medical Associates, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1881192409
  NPD
• Norton Childrens Medical Group, LLC

  • Pediatrics Physician
  • Louisville, KY
  • NPI 1326695255

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1365120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602374400000",
    "number": "1508109844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3999 DUTCHMANS LN STE 6F",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402074724",
            "telephone_number": "502-394-5678",
            "fax_number": "502-394-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAGAMI",
        "first_name": "KAITLIN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-05",
        "last_updated": "2020-10-11",
        "certification_date": "2020-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100248600",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kzagami151864@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "3999 Dutchmans Ln Ste 6F",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074724",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3999 Dutchmans Ln Ste 6F",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074724",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "KEAVENY",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Nicole Zachman
• Zack R Stearns MD Orthopedic Bone & Joint Specialists PLLC
• Dwinelva Z Zackery, LCSW
• Nagma Zafar, MD
• Zafrin B Syed, M.D., PLLC
• Nikolaos Christos Zagorianos, O.D.
• Kari J. Zahorik, M.D.
• Ezequiel Ernesto Zaidenberg, MD
• Bushra Zaidi, MD
• Kashaf Zaidi

• Physician Assistant in Louisville, KY
• Providers in Louisville, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2020; 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.

Verify at the official NPI Registry.