Individual provider Active NPI

Catherine Roland, PHD, CPNP

  • Pediatric Nurse Practitioner
  • Vandenberg AFB, CA
National Provider Identifier
1811016579
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
95007939 Issued in CA
Practice address
338 S Dakota Ave
Vandenberg AFB, CA 93437-6307
Phone
(805) 606-2273
NPI assigned
Mar 27, 2007
Last updated
Jul 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP6895 AZ
Pediatric Nurse Practitioner 363LP0200X 10018872 OR
Pediatric Nurse Practitioner 363LP0200X CNP81654 ME
Pediatric Nurse Practitioner 363LP0200X 95007939 CA Primary
Pediatrics Physician 208000000X 95007939 CA

Addresses

Primary practice location

338 S Dakota Ave
Vandenberg AFB, CA 93437-6307

Mailing address

338 S Dakota Ave
Vandenberg AFB, CA 93437-6307
Phone (805) 606-2273

Other identifiers 1

IdentifierTypeStateIssuer
1164477562-025MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210720002963 CA Practitioner - Nurse Practitioner 0941364616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
95007939CAMDPediatrics Physician
AP6895AZMDPediatric Nurse Practitioner
CNP81654MEMDPediatric Nurse Practitioner
10018872ORMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dap Health, Inc. Current Accepting new patients
DHHS PHS Naihs Fort Defiance Hospital Past Accepting new patients

Organizations & group practices 2

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1811016579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "338 S DAKOTA AVE",
            "city": "VANDENBERG AFB",
            "state": "CA",
            "postal_code": "934376307",
            "telephone_number": "805-606-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "338 S DAKOTA AVE",
            "city": "VANDENBERG AFB",
            "state": "CA",
            "postal_code": "934376307",
            "telephone_number": "805-606-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLAND",
        "first_name": "CATHERINE",
        "credential": "PHD, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AZ",
            "license": "AP6895",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OR",
            "license": "10018872",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ME",
            "license": "CNP81654",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95007939",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "95007939",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164477562-025",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vandenberg AFB, CA

Sources for this page

Verify at the official NPI Registry.