NPIMap

Individual provider Active NPI

Katherine Kavanaugh, ARNP

  • Critical Care Medicine Nurse Practitioner
  • Cedar Rapids, IA
National Provider Identifier
1821058306
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
078725 Issued in IA
Practice address
600 7TH St SE
Cedar Rapids, IA 52401-2112
Phone
(319) 221-8800
Fax
(319) 221-8787
NPI assigned
Mar 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X 078725 IA Primary

Addresses

Primary practice location

600 7TH St SE
Cedar Rapids, IA 52401-2112

Mailing address

PO Box 1824
Cedar Rapids, IA 52406-1824
Phone (319) 369-4505

Other identifiers 1

IdentifierTypeStateIssuer
0470948MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180315001495 CO Practitioner - Nurse Practitioner 6103850235 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Banner Health Physicians Colorado LLC 278 clinicians

Practice addresses (Care Compare)

1801 16TH St
Suite C2B
Greeley, CO 80631-5154
Phone (970) 810-4121

Hospital & facility affiliations

  • Banner North Colorado Medical Center Hospital, Greeley, CO, CCN 060001
  • Sterling Regional Medcenter Hospital, Sterling, CO, CCN 060076
  • Cheyenne Regional Medical Center Hospital, Cheyenne, WY, CCN 530014
  • Banner Fort Collins Medical Center Hospital, Fort Collins, CO, CCN 060126
  • East Morgan County Hospital Hospital, Brush, CO, CCN 061303

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
078725IAMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians Colorado LLC CurrentSince Mar 5, 2018 Accepting new patients
Banner Hospital Based Physicians Colorado LLC CurrentSince Mar 17, 2020 Accepting new patients
Banner Health Physicians Colorado LLC CurrentSince Mar 5, 2018 Accepting new patients
Banner Hospital Based Physicians Colorado LLC Current Accepting new patients
Banner Hospital Based Physicians Colorado LLC CurrentSince Mar 17, 2020 Accepting new patients
Respiratory & Critical Care Associates PLLC Past Accepting new patients
Respiratory and Critical Care Associates Past Accepting new patients
Trinity Regional Medical Center Past Accepting new patients
Banner Health Physicians Colorado LLC Past Accepting new patients
Eastern Iowa Sleep Center, LLC Past Accepting new patients

Locations

4700 Lady Moon Dr
Ste C1
Fort Collins, CO 80528
Phone (970) 821-4500

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

1900 Boise Ave
Ste 220
Loveland, CO 80538
Phone (970) 203-2120

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1821058306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1824",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524061824",
            "telephone_number": "319-369-4505",
            "fax_number": "319-369-4677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 7TH ST SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524012112",
            "telephone_number": "319-221-8800",
            "fax_number": "319-221-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVANAUGH",
        "first_name": "KATHERINE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "IA",
            "license": "078725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0470948",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.