Individual provider Active NPI

Katherine Celine Boston, NP-C

  • Family Nurse Practitioner
  • Westmont, IL
National Provider Identifier
1780076679
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.012438 Issued in IL
Practice address
1010 Executive Drive
Suite 200
Westmont, IL 60559
Phone
(312) 835-7204
NPI assigned
Mar 2, 2015
Last updated
Dec 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209.012438 IL Primary

Addresses

Primary practice location

1010 Executive Drive
Suite 200
Westmont, IL 60559

Mailing address

1010 Executive Drive
Suite 200
Westmont, IL 60559
Phone (312) 835-7204

Other names 1

  • Katherine Smith Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20151223001811 IL Practitioner - Nurse Practitioner 1759682305 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
209.012438ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Current Accepting new patients
HCR Manorcare Medical Services of Florida LLC CurrentSince Feb 8, 2016 Accepting new patients
Vpa PC CurrentSince Sep 4, 2023 Accepting new patients
Vpa PC CurrentSince Sep 4, 2023 Accepting new patients

Locations

600 W Ogden Ave
Hinsdale, IL 60521
Phone (630) 325-9630

512 E Ogden Ave
Westmont, IL 60559
Phone (630) 323-4000

L2540
Columbus, OH 43260

Interoperability endpoints

  • Direct secure messaging: katherine.smith.p1@direct.alegiscare.nextgenshare.com

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": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1780076679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 EXECUTIVE DRIVE",
            "address_2": "SUITE 200",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "60559",
            "telephone_number": "312-835-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 EXECUTIVE DRIVE",
            "address_2": "SUITE 200",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "60559",
            "telephone_number": "312-835-7204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTON",
        "first_name": "KATHERINE",
        "middle_name": "CELINE",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-02",
        "last_updated": "2023-12-13",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.012438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "SMITH",
            "credential": "NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Westmont, IL

Sources for this page

Verify at the official NPI Registry.