Kathryn L Hackman, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

113135 Issued in MO

Practice address

545 Branson Landing Blvd
Suite 100
Branson, MO 65616

Phone

(417) 335-7587

Fax

(417) 335-7529

NPI assigned

Aug 7, 2006

Last updated

Oct 29, 2008By 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 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225238400000",
    "number": "1760491641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 BRANSON LANDING BLVD",
            "address_2": "SUITE 100",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "65616",
            "telephone_number": "417-335-7587",
            "fax_number": "417-335-7529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 BRANSON LANDING BLVD",
            "address_2": "SUITE 100",
            "city": "BRANSON",
            "state": "MO",
            "postal_code": "65616",
            "telephone_number": "417-335-7587",
            "fax_number": "417-335-7529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKMAN",
        "first_name": "KATHRYN",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2008-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "113135",
            "primary": true
        },
        {
            "code": "163WX0106X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Occupational Health",
            "state": "MO",
            "license": "113135",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "209396704",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COX HEALTH SYSTEMS",
            "identifier": "2578",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "126814",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00365026",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "250766",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "428135354",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Ladane Green
• Justin Matthew Gregory, DC
• Micah Griffin, PA-C
• Allison Jean Griffith, O.D.
• Richard Gene Griffith, MD
• Arthur E. Hale Jr., MD
• Kimberly K Hale, PT
• Alexis Hall, RN BSN
• Chandler Ashton Hall, DDS
• Courtney Hamilton, PLPC

• Family Nurse Practitioner in Branson, MO
• Providers in Branson, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; 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.