Active NPI
Katelyn Rose Denison, RN
- Registered Nurse
- Shoshone, ID
National Provider Identifier
1770110959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 56539
- Practice address
- 712 W 5TH St
Shoshone, ID 83352-5414 - Phone
- (208) 420-4435
- NPI assigned
- Mar 26, 2020
- Last updated
- Mar 26, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 56539 | ID | Primary |
Addresses
Primary practice location
712 W 5TH St
Shoshone, ID 83352-5414
Mailing address
712 W 5TH St
Shoshone, ID 83352-5414
Phone (208) 420-4435
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56539 | ID | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585180800000",
"number": "1770110959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "712 W 5TH ST",
"city": "SHOSHONE",
"state": "ID",
"postal_code": "833525414",
"telephone_number": "208-420-4435"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "712 W 5TH ST",
"city": "SHOSHONE",
"state": "ID",
"postal_code": "833525414",
"telephone_number": "208-420-4435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENISON",
"first_name": "KATELYN",
"middle_name": "ROSE",
"name_prefix": "Ms.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-26",
"last_updated": "2020-03-26",
"certification_date": "2020-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "ID",
"license": "56539",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shoshone, ID
- Melissa Brown, RN
- Cascades at Lincoln County, LLC (Lincoln County Care Center)
- Charolais Care IV, Inc (Lincoln County Care Center)
- Martha Mary Clements, PT
- Keith E Davis, M.D.
- Family Health Services Corporation
- Family Health Services Corporation
- Gooding Pharmacy Inc (Shoshone Pharmacy)
- Barbara Hapayan, NP
- Sara Jesse Harding
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.