Individual provider Active NPI

Katherine Hall Kruppenbach, FNP-C

  • Nurse Practitioner
  • Asheboro, NC
National Provider Identifier
1518485333
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5009791 Issued in NC
Practice address
223 W Ward St Ste B
Asheboro, NC 27203
Phone
(336) 702-1731
Fax
(336) 702-3014
NPI assigned
Aug 31, 2017
Last updated
Nov 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 207610 NC
Nurse Practitioner 363L00000X 5009791 NC Primary
Family Nurse Practitioner 363LF0000X 207610 NC

Addresses

Primary practice location

223 W Ward St Ste B
Asheboro, NC 27203

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-1331

Other practice location 1

190 Riverview St
Franklin, NC 28734-2612
Phone (828) 349-6804

Other practice location 2

190 Riverview St
Franklin, NC 28734-2612
Phone (828) 349-6804

Other names 1

  • Ms. Katherine Marie Hall Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20171016002262 NC Practitioner - Nurse Practitioner 6709152929

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207610NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Health Care LLC Past Accepting new patients

Organizations & group practices 1

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": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1518485333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-1331",
            "fax_number": "336-716-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 W WARD ST STE B",
            "city": "ASHEBORO",
            "state": "NC",
            "postal_code": "27203",
            "telephone_number": "336-702-1731",
            "fax_number": "336-702-3014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "190 Riverview St",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "NC",
            "postal_code": "287342612",
            "country_code": "US",
            "telephone_number": "828-349-6804",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "190 Riverview St",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "NC",
            "postal_code": "287342612",
            "country_code": "US",
            "telephone_number": "828-349-6804",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRUPPENBACH",
        "first_name": "KATHERINE",
        "middle_name": "HALL",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "207610",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5009791",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "207610",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "HALL",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Asheboro, NC

Sources for this page

Verify at the official NPI Registry.