Active NPI
Kathleen Nolan, MD, MSL
- Pediatrics Physician
- Shandaken, NY
National Provider Identifier
1518129717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 175109
- Practice address
- 7194 State Route 28
Shandaken, NY 12480-5004 - Phone
- (845) 688-9702
- Fax
- (845) 679-6973
- NPI assigned
- Jun 28, 2008
- Last updated
- Sep 18, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 175109 | NY | Primary |
Addresses
Primary practice location
7194 State Route 28
Shandaken, NY 12480-5004
Mailing address
PO Box 16
Mount Tremper, NY 12457-0016
Phone (845) 688-9702
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Master of Science - Law
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 175109 | NY | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347926400000",
"number": "1518129717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16",
"city": "MOUNT TREMPER",
"state": "NY",
"postal_code": "124570016",
"telephone_number": "845-688-9702",
"fax_number": "845-679-6973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7194 STATE ROUTE 28",
"city": "SHANDAKEN",
"state": "NY",
"postal_code": "124805004",
"telephone_number": "845-688-9702",
"fax_number": "845-679-6973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLAN",
"first_name": "KATHLEEN",
"name_prefix": "Dr.",
"credential": "MD, MSL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-28",
"last_updated": "2012-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NY",
"license": "175109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shandaken, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.