Kathryn Okeefe, NP
Individual provider Active NPI Nurse Practitioner · Charlottesvle, VA
NPI 1659930758 · NPPES record last updated May 2, 2023
Key facts
- NPI
- 1659930758
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- C-APN.0001501-C-NP (CO)
- Practice address
- 2207 Jefferson Park Ave Apt B
Charlottesvle, VA 22903-3017 - Phone
- (443) 802-5577
- NPI assigned
- Jun 12, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200406001032 | NM | Practitioner - Nurse Practitioner | 3173952512 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-APN.0001501-C-NP | CO | MD | Nurse Practitioner |
| APN.0995634-NP | CO | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Juan Regional Medical Center Inc | Current |
Accepting new patients | |
| San Juan Regional Medical Center Inc | Current | Accepting new patients | |
| San Juan Regional Medical Center Inc | Current |
Accepting new patients |
Locations
4820 E Main St
Ste 2
Farmington, NM 87402
Phone (505) 609-6610
801 W Maple St
Farmington, NM 87401
Phone (505) 325-5011
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | APN.0995634-NP | CO | |
| Family Nurse Practitioner | 363LF0000X | APN.0995634-NP | CO | |
| Gerontology Nurse Practitioner | 363LG0600X | APN.0995634-NP | CO | |
| Nurse Practitioner | 363L00000X | C-APN.0001501-C-NP | CO | Yes |
Addresses
Primary practice location
2207 Jefferson Park Ave Apt B
Charlottesvle, VA 22903-3017
Mailing address
2207 Jefferson Park Ave Apt B
Charlottesvle, VA 22903-3017
Phone (443) 802-5577
Other practice location 1
1 Mercado St Ste 160
Durango, CO 81301-7309
Phone (970) 385-9850
Other providers in Charlottesvle, VA
- Rachel Marie Chung
- Sarah Davis
- Hospice of the Piedmont, Inc.
- Amanda Raquel Medina Padilla
- Nathan Hefner LPC PC
- Michael Cannon Williamson
All providers in Charlottesvle, VA · Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.