Individual provider Active NPI

Carolann Roberta Kohtz, RN

  • Registered Nurse
  • Saint Louis, MO
National Provider Identifier
1649979881
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
2015026975 Issued in MO
Practice address
1107 Mississippi Ave Apt 305
Saint Louis, MO 63104-2461
Phone
(309) 338-4510
NPI assigned
Feb 27, 2023
Last updated
Feb 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 2015026975 MO Primary

Addresses

Primary practice location

1107 Mississippi Ave Apt 305
Saint Louis, MO 63104-2461

Mailing address

1107 Mississippi Ave Apt 305
Saint Louis, MO 63104-2461
Phone (309) 338-4510

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2015026975MOMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1649979881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 MISSISSIPPI AVE APT 305",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631042461",
            "telephone_number": "309-338-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 MISSISSIPPI AVE APT 305",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631042461",
            "telephone_number": "309-338-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHTZ",
        "first_name": "CAROLANN",
        "middle_name": "ROBERTA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2015026975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.