Kathlene CM Vannoy, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

347317 Issued in NY

Practice address

101 Greenwich St Ste 403
New York, NY 10006-1895

Phone

(917) 261-4414

Fax

(917) 261-4420

NPI assigned

Jan 11, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 15

Addresses

Other names 1

• Kathlene Nassif Former name

Medicare fee-for-service enrollment

Enrolled in LA, OK, AL, MD4 enrollments

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 4

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathlene.vannoy@337577483108356.direct.elationemr.com

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.

• Lifemd Atlantic Patient Medical Care PC

  • Clinic/Center
  • Hoboken, NJ
  • NPI 1164100657

  Family Medicine

  NPD
• Eden Health Medical of DC PC

  • Internal Medicine Physician
  • Buffalo, NY
  • NPI 1790368173
  NPD (past)
• Eden Health Medical of NJ PC

  • Internal Medicine Physician
  • Buffalo, NY
  • NPI 1790395499
  NPD (past)
• Eden Health Medical of Il LTD

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1083297469
  NPD (past)
• Hunterdon Specialty Care, PC

  dba Advanced Gastroenterology & Nutrition

  • Gastroenterology Physician
  • Flemington, NJ
  • NPI 1790156388
  NPD (past)
• Lifemd Kansas Patient Medical Care PA

  • Clinic/Center
  • Overland Park, KS
  • NPI 1073353850

  Family Medicine

  NPD (past)
• Puopolo MD PC

  • Clinic/Center
  • Los Angeles, CA
  • NPI 1477230928

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1821454596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1591 JACKSON ST APT 18",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941093151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 GREENWICH ST STE 403",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100061895",
            "telephone_number": "917-261-4414",
            "fax_number": "917-261-4420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "660 4th St # 202",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941071618",
            "country_code": "US",
            "telephone_number": "833-334-6393",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1615 L St NW Ste 410",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200365612",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "131 S Dearborn St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606035517",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "fax_number": "917-261-4420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Connell Dr",
            "address_purpose": "LOCATION",
            "city": "Berkeley Heights",
            "state": "NJ",
            "postal_code": "079222805",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1501 S Clinton St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212245730",
            "country_code": "US",
            "telephone_number": "917-261-4414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "522 2nd St Ste 101",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941071427",
            "country_code": "US",
            "telephone_number": "415-237-1378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANNOY",
        "first_name": "KATHLENE",
        "middle_name": "CM",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-11",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "106955",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "832676",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024179743",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "106955",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "5008291",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DC",
            "license": "RN1058968",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5008291",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R245037",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "DE",
            "license": "LG-0011488",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ01169500",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209.022562",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "247775",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "9193",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1008379",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "347317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLENE",
            "last_name": "NASSIF",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maya Vankineni, M.D.
• Brian Seth Vann Jr., O.D.
• Elizabeth Vann
• Jessica Robin Vanname, PA-C
• Andrea Bragdon Vannelli, DAC, LAC
• Susan J Vannucci, PHD, RD
• Maija Elizabeth Vanravenswaay, LMSW
• Sarah Haseltine Vantassel, MD
• Katherine Marlene Vanterpool
• Shantell P Vanterpool, M.S.ED.

• Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.