Active NPI
Kathy Camellia Lightfoot, PHYSICIAN ASSISTANTS
- Physician Assistant
- Baltimore, MD
National Provider Identifier
1851986244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C02520
- Practice address
- BRC, 251 Bayview Blvd
Baltimore, MD 21224-2816 - Phone
- (443) 889-5989
- Fax
- (443) 740-2834
- NPI assigned
- Mar 8, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C02520 | MD | Primary |
Addresses
Primary practice location
BRC, 251 Bayview Blvd
Baltimore, MD 21224-2816
Mailing address
BRC, 251 Bayview Blvd
Baltimore, MD 21224-2816
Phone (443) 889-5989
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | kathy.lightfoot@nih.gov | Direct | National Institute of Health |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C02520 | MD | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615161600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1851986244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BRC, 251 BAYVIEW BLVD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212242816",
"telephone_number": "443-889-5989",
"fax_number": "443-740-2834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BRC, 251 BAYVIEW BLVD",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212242816",
"telephone_number": "443-889-5989",
"fax_number": "443-740-2834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIGHTFOOT",
"first_name": "KATHY",
"middle_name": "CAMELLIA",
"credential": "PHYSICIAN ASSISTANTS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-08",
"last_updated": "2021-03-08",
"certification_date": "2021-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C02520",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "kathy.lightfoot@nih.gov",
"affiliation": "Y",
"endpointDescription": "email address",
"affiliationName": "National Institute of Health",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CSV",
"address_1": "BRC, 251 Bayview Blvd",
"city": "Baltimore",
"state": "MD",
"country_code": "US",
"postal_code": "212242816",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.