Individual provider Active NPI

Kathryn Elizabeth Holliday, NP

  • Pediatric Nurse Practitioner
  • Syracuse, NY
National Provider Identifier
1922446798
Registry record updated Mar 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F382384-1 Issued in NY
Practice address
4900 Broad Rd
Syracuse, NY 13215
Phone
(315) 492-5437
Fax
(315) 492-5502
NPI assigned
Jun 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2018

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 F382384-1 NY Primary

Addresses

Primary practice location

4900 Broad Rd
Syracuse, NY 13215

Mailing address

251 Salina Meadows Pkwy
Ste 100
Syracuse, NY 13212-4516
Phone (315) 464-2000

Other names 1

  • Kathryn Elizabeth Degirolamo Former name

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F382384-1NYMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521072000000",
    "number": "1922446798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 SALINA MEADOWS PKWY",
            "address_2": "STE 100",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132124516",
            "telephone_number": "315-464-2000",
            "fax_number": "315-464-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 BROAD RD",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13215",
            "telephone_number": "315-492-5437",
            "fax_number": "315-492-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIDAY",
        "first_name": "KATHRYN",
        "middle_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-13",
        "last_updated": "2018-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F382384-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "DEGIROLAMO",
            "middle_name": "ELIZABETH",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.