Individual provider Active NPI

Kathryn A Hemker, PHD

  • Clinical Psychologist
  • Fort Bliss, TX
National Provider Identifier
1750386967
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5239 Issued in OH
Practice address
20415 Gulf Victory Way
Fort Bliss, TX 79918-8066
Phone
(304) 834-4303
NPI assigned
Jun 15, 2005
Last updated
Oct 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 5239 OH Primary

Addresses

Primary practice location

20415 Gulf Victory Way
Fort Bliss, TX 79918-8066

Mailing address

20415 Gulf Victory Way
Fort Bliss, TX 79918-8066
Phone (304) 834-4303

Other identifiers 2

IdentifierTypeStateIssuer
2186307MedicaidOH
9201027000MedicaidWV

Other names 1

  • Kathryn H Bobbitt Former name

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
5239OHMDClinical Psychologist
702WVMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
GR&W, Inc PastSince Feb 8, 2016 Accepting new patients
Kathryn H Bobbitt, LLC Psychologist PastSince Oct 1, 2003 Accepting new patients
Marietta Memorial Hospital Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1750386967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20415 GULF VICTORY WAY",
            "city": "FORT BLISS",
            "state": "TX",
            "postal_code": "799188066",
            "telephone_number": "304-834-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20415 GULF VICTORY WAY",
            "city": "FORT BLISS",
            "state": "TX",
            "postal_code": "799188066",
            "telephone_number": "304-834-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEMKER",
        "first_name": "KATHRYN",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-15",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "5239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2186307",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9201027000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "BOBBITT",
            "middle_name": "H",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Bliss, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; 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.