Individual provider Active NPI

Kathryn M Vroom, FNP-C

  • Family Nurse Practitioner
  • Munster, IN
National Provider Identifier
1841930468
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71012480A Issued in IN
Practice address
801 Macarthur Blvd Ste 405
Munster, IN 46321-2919
Phone
(219) 836-5167
Fax
(219) 836-5249
NPI assigned
Mar 31, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28191569A IN
Family Nurse Practitioner 363LF0000X 71012480A IN Primary

Addresses

Primary practice location

801 Macarthur Blvd Ste 405
Munster, IN 46321-2919

Mailing address

8558 Broadway
Merrillville, IN 46410-7032
Phone (193) 927-0842

Other practice location 1

901 MacArthur Blvd
Munster, IN 46321-2901
Phone (219) 703-1991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20220414001054 IN Practitioner - Nurse Practitioner 8628464922 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Care Network IncGroup PAC ID 3678737012, 378 clinicians

Practice addresses (Care Compare)

801 Macarthur Blvd
Suite 405
Munster, IN 46321-2919
Phone (219) 836-5167

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28191569AINMDFamily Nurse Practitioner
71012480AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Network Inc CurrentSince May 1, 2022 Accepting new patients

Locations

8558 Broadway
Merrillville, IN 46410
Phone (219) 392-7084

9130 Columbia Ave
Ste A
Munster, IN 46321
Phone (219) 365-1166

901 MacArthur Blvd
Munster, IN 46321
Phone (219) 703-1443

801 MacArthur Blvd
Ste 405
Munster, IN 46321
Phone (219) 836-5040

Interoperability endpoints

  • Direct secure messaging: kvroom10782@ssdirect.comhs.org

Organizations & group practices 1

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649808000000",
    "number": "1841930468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8558 BROADWAY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464107032",
            "telephone_number": "193-927-0842",
            "fax_number": "219-703-6854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MACARTHUR BLVD STE 405",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212919",
            "telephone_number": "219-836-5167",
            "fax_number": "219-836-5249"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 MacArthur Blvd",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "463212901",
            "country_code": "US",
            "telephone_number": "219-703-1991",
            "fax_number": "219-836-6796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VROOM",
        "first_name": "KATHRYN",
        "middle_name": "M",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28191569A",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012480A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.