Individual provider Active NPI

Kathleen Flawagan, APN-BC

  • Adult Health Nurse Practitioner
  • North Bergen, NJ
National Provider Identifier
1710301841
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NJ00431100 Issued in NJ
Practice address
7600 River Road
Palisades Medical Center
North Bergen, NJ 07047
Phone
(201) 854-5005
Fax
(201) 854-5224
NPI assigned
Feb 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NJ00431100 NJ Primary

Addresses

Primary practice location

7600 River Road
Palisades Medical Center
North Bergen, NJ 07047

Mailing address

7600 River Road
Palisades Medical Center
North Bergen, NJ 07047
Phone (201) 854-5005

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

LicenseStateTypeSpecialty
26NJ00431100NJMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1710301841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 RIVER ROAD",
            "address_2": "PALISADES MEDICAL CENTER",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "07047",
            "telephone_number": "201-854-5005",
            "fax_number": "201-854-5224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 RIVER ROAD",
            "address_2": "PALISADES MEDICAL CENTER",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "07047",
            "telephone_number": "201-854-5005",
            "fax_number": "201-854-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLAWAGAN",
        "first_name": "KATHLEEN",
        "credential": "APN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-10",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NJ00431100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bergen, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; 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.