Katrina Raenae Staley, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN.0998883-NP Issued in CO

Practice address

2928 W 10TH St
Greeley, CO 80634-5426

Phone

(970) 584-2100

Fax

(970) 584-2101

NPI assigned

Jul 13, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Katrina Raenae Karakas Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• JG LLC

  • Primary Care Clinic/Center
  • Greeley, CO
  • NPI 1881101640

  Family

  Medicare reassignment NPD

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703376000000",
    "number": "1891474151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1576 CLARENDON DR",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805502681",
            "telephone_number": "801-388-6335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2928 W 10TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806345426",
            "telephone_number": "970-584-2100",
            "fax_number": "970-584-2101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1576 Clarendon Dr",
            "address_purpose": "LOCATION",
            "city": "Windsor",
            "state": "CO",
            "postal_code": "805502681",
            "country_code": "US",
            "telephone_number": "801-388-6335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STALEY",
        "first_name": "KATRINA",
        "middle_name": "RAENAE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-13",
        "last_updated": "2023-12-24",
        "certification_date": "2023-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0998883-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATRINA",
            "last_name": "KARAKAS",
            "middle_name": "RAENAE",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• SSC Greeley Centennial Operating Company LLC
• SSC Greeley Kenton Operating Company LLC
• SSC Greeley Kenton Operating Company LLC
• Samantha Stadjuhar Whitmore
• Sheldon Gregory Stadnyk, M.D.
• Stephanie Rose Stamos
• McKenzie Stampfli, MD
• Kelly Standke, MA, CCC-SLP
• Carly Standley
• Jenny Stanford, RPH

• Family Nurse Practitioner in Greeley, CO
• Providers in Greeley, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2023; 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.