Katherine Shepherd Anderson, ACNP- BC
Individual provider Active NPI Acute Care Nurse Practitioner · Colleyville, TX
NPI 1730710641 · NPPES record last updated Jan 29, 2020
Key facts
- NPI
- 1730710641
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acute Care Nurse Practitioner 363LA2100X
- License
- 0001890 (CO)
- Practice address
- 2205 Collins Path
Colleyville, TX 76034-7325 - Phone
- (703) 485-6110
- NPI assigned
- Jan 29, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 5
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Intermountain Medical Group Grand Junction, LLC
Practice addresses (Care Compare)
1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864
201 W Park Dr
201 West Park Cardiology
Grand Junction, CO 81505-1469
Phone (970) 298-3050
2635 N 7TH St
Grand Junction, CO 81501-8209
2686 Patterson Rd
Grand Junction, CO 81506-8817
Phone (970) 298-2001
360 W Park Dr
Intermountain Health Heart and Vascular Wes
Grand Junction, CO 81505-1448
Phone (970) 298-3050
Hospital & facility affiliations
- Intermountain Health St. Mary'S Regional Hospital
- Delta County Memorial Hospital
- Grand River Hospital District
- Montrose Regional Health
- San Juan Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CO
- 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 |
|---|---|---|---|---|
| I20200504000139 | CO | Practitioner - Nurse Practitioner | 2961833181 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0001890 | CO | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Intermountain Medical Group Grand Junction, LLC | Current |
Accepting new patients | |
| Intermountain Medical Group Grand Junction, LLC | Current |
Accepting new patients | |
| St Mary'S Hospital and Medical Center, Inc | Past | Accepting new patients | |
| St Mary'S Hospital and Medical Center, Inc | Past | Accepting new patients |
Locations
1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810
360 W Park Dr
Grand Junction, CO 81505
Phone (970) 244-2482
2643 Patterson Rd
Ste 403
Grand Junction, CO 81506
Phone (970) 298-7662
1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864
Interoperability endpoints
- katherine.anderson.1@26283.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 0001890 | CO | Yes |
Addresses
Primary practice location
2205 Collins Path
Colleyville, TX 76034-7325
Mailing address
2205 Collins Path
Colleyville, TX 76034-7325
Phone (703) 485-6110
Other providers in Colleyville, TX
- Cynthia Lynne Alvis I
- Amb Eeg LLC
- American Arthritis & Rheumatology Associates-TX PLLC
- American Pain & Wellness PA
- Anchor Dental PLLC
- Todd Anderson
- Answers for Anxiety Counseling Center
- Apollo Monitoring Services, LLC
- Arshan Consulting, LLC
- Myrna Loy Ashby
All providers in Colleyville, TX · Acute Care Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2020. 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).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.