Individual provider Active NPI

Kathryn Stone, NP-C

  • Primary Care Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1871079103
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APN.0994019-NP Issued in CO
Practice address
1120 Minnequa Ave
Pueblo, CO 81004-3734
Phone
(719) 281-3285
NPI assigned
Jul 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APN.0994019-NP CO Primary

Addresses

Primary practice location

1120 Minnequa Ave
Pueblo, CO 81004-3734

Mailing address

1120 Minnequa Ave
Pueblo, CO 81004-3734
Phone (719) 281-3285

Other practice location 1

5023 W 120th Ave
#312
Broomfield, CO 80020-5606
Phone (720) 644-9355

Other practice location 2

12230 Lioness Way
Parker, CO 80134
Phone (720) 644-9355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20181129002711 CO Practitioner - Nurse Practitioner 7618211798 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Primary CareGroup PAC ID 3577988864, 9 clinicians

Practice addresses (Care Compare)

75 Printers Pkwy
Suite 200
Colorado Springs, CO 80910-3142
Phone (719) 300-8433

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0994019-NPCOMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Primary Care Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1871079103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 MINNEQUA AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043734",
            "telephone_number": "719-281-3285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 MINNEQUA AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810043734",
            "telephone_number": "719-281-3285"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5023 W 120th Ave",
            "address_2": "#312",
            "address_purpose": "LOCATION",
            "city": "Broomfield",
            "state": "CO",
            "postal_code": "800205606",
            "country_code": "US",
            "telephone_number": "720-644-9355",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12230 Lioness Way",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "80134",
            "country_code": "US",
            "telephone_number": "720-644-9355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STONE",
        "first_name": "KATHRYN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-19",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CO",
            "license": "APN.0994019-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.