Kathleen M Whitaker, CNS

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

28056006A Issued in IN

Practice address

209 W North St
Lebanon, IN 46052

Phone

(765) 481-2015

Fax

(765) 481-2270

NPI assigned

Nov 6, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Aug 19, 2015 through Aug 19, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Specialist

State licenses

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

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428537600000",
    "number": "1780838557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W. NORTH ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "46052",
            "telephone_number": "765-481-2015",
            "fax_number": "765-481-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W NORTH ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "46052",
            "telephone_number": "765-481-2015",
            "fax_number": "765-481-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2015-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "IN",
            "license": "70000213",
            "primary": false
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "IN",
            "license": "70000213",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "IN",
            "license": "28056006A",
            "primary": true
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "IN",
            "license": "28056006A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200983160",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Frederick Werry II, DDS
• Jayla Wesley, RBT
• Amelia Ann West, LMHC
• Kenzlie Ann Westerfield
• Jordan Whitaker
• Abby Elizabeth White
• Endiya White, RBT
• Whitestar PC
• Nora Camille Wilcox, FNP
• Courtney Wiley, LCSW

• Psychiatric/Mental Health Registered Nurse in Lebanon, IN
• Providers in Lebanon, IN by specialty
• Psychiatric/Mental Health Registered Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.