Active NPI
Katie Gathman
- Registered Dietitian
- Austin, TX
National Provider Identifier
1689407017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 097700
- Practice address
- 3724 Jefferson St Ste 104
Austin, TX 78731-6204 - Phone
- (512) 692-7045
- NPI assigned
- Aug 21, 2024
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 097700 | IA | Primary |
Addresses
Primary practice location
3724 Jefferson St Ste 104
Austin, TX 78731-6204
Mailing address
2600 Woodland Ave
West Des Moines, IA 50266-2158
Phone (515) 494-3692
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241115001175 | TX | Practitioner - Registered Dietitian Or Nutrition Professional | 1557895307 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Nourish, Inc.
Practice addresses (Care Compare)
3724 Jefferson St
Suite 104
Austin, TX 78731-6204
Phone (512) 693-7045
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 097700 | IA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Current | Accepting new patients |
Locations
500 Westover Dr
Sanford, NC 27330
Phone (478) 766-4000
3724 Jefferson St
Ste 104
Austin, TX 78731
Phone (512) 399-9039
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1724198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725408000000",
"number": "1689407017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 WOODLAND AVE",
"city": "WEST DES MOINES",
"state": "IA",
"postal_code": "502662158",
"telephone_number": "515-494-3692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3724 JEFFERSON ST STE 104",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787316204",
"telephone_number": "512-692-7045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GATHMAN",
"first_name": "KATIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-21",
"last_updated": "2024-09-04",
"certification_date": "2024-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "IA",
"license": "097700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.