Kathryn Emily Stoodt, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5014089 Issued in NC

Practice address

2544 Court Dr Ste F
Gastonia, NC 28054-3450

Phone

(704) 864-8302

Fax

(704) 864-0228

NPI assigned

Aug 14, 2020

Last updated

Dec 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kathryn Emily Fortin Former name

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Polyclinic Medical Center, Inc.

  • Critical Care Medicine (Internal Medicine) Physician
  • Matthews, NC
  • NPI 1821059650
  NPD (past)

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701734400000",
    "number": "1740891423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15611 DEHAVILLAND DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282787257",
            "telephone_number": "546-292-3189",
            "fax_number": "704-971-0035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2544 COURT DR STE F",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280543450",
            "telephone_number": "704-864-8302",
            "fax_number": "704-864-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOODT",
        "first_name": "KATHRYN",
        "middle_name": "EMILY",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-14",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5014089",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "FORTIN",
            "middle_name": "EMILY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maria Still
• Van J Stitt Jr., MD
• Irina Stoianov
• Melissa Stokes, MSW, LCSWA
• Jasmine Sicilia Stone, PA
• Stover & Stover DDS PA
• Stover Family Dentistry
• Douglas Lee Stover, DDS
• Jenna Stover, DDS
• Susan I Stover, DDS

• Family Nurse Practitioner in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.