Individual provider Active NPI

Catherine Ann Roche, ARNP

  • Pediatric Nurse Practitioner
  • Davenport, IA
National Provider Identifier
1871928093
Registry record updated Sep 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
C117430 Issued in IA
Practice address
5510 Utica Ridge Rd
Suite 100
Davenport, IA 52807-2946
Phone
(563) 424-2025
Fax
(563) 424-2042
NPI assigned
Sep 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X C117430 IA Primary

Addresses

Primary practice location

5510 Utica Ridge Rd
Suite 100
Davenport, IA 52807-2946

Mailing address

5510 Utica Ridge Rd
Suite 100
Davenport, IA 52807-2946
Phone (563) 424-2025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20151008001267 IA Practitioner - Nurse Practitioner 5890003099

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Luke'S Methodist Hospital Current Accepting new patients
Pediatric Group Associates, SC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: croche157490@direct.unitypoint.org

Organizations & group practices 2

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": "1378425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378425600000",
    "number": "1871928093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5510 UTICA RIDGE RD",
            "address_2": "SUITE 100",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072946",
            "telephone_number": "563-424-2025",
            "fax_number": "563-424-2042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5510 UTICA RIDGE RD",
            "address_2": "SUITE 100",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072946",
            "telephone_number": "563-424-2025",
            "fax_number": "563-424-2042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHE",
        "first_name": "CATHERINE",
        "middle_name": "ANN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-06",
        "last_updated": "2013-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IA",
            "license": "C117430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.