Active NPI
Kaitlin Rose Kolb
- Pediatric Nurse Practitioner
- New Hyde Park, NY
National Provider Identifier
1649885336
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 383170
- Practice address
- 269-01 76TH Ave
RM CH 222
New Hyde Park, NY 11040 - Phone
- (516) 470-3422
- NPI assigned
- Sep 10, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 383170 | NY | Primary |
Addresses
Primary practice location
269-01 76TH Ave
RM CH 222
New Hyde Park, NY 11040
Mailing address
269-01 76TH Ave
RM CH 222
New Hyde Park, NY 11040
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 383170 | NY | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599696000000",
"number": "1649885336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "269-01 76TH AVE",
"address_2": "RM CH 222",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "11040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "269-01 76TH AVE",
"address_2": "RM CH 222",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "11040",
"telephone_number": "516-470-3422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLB",
"first_name": "KAITLIN",
"middle_name": "ROSE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-10",
"last_updated": "2020-09-10",
"certification_date": "2020-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "NY",
"license": "383170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Hyde Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.