Katie Defore, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

E4912 Issued in AR

Practice address

225 E Jackson Ave
Jonesboro, AR 72401-3119

Phone

(870) 972-4100

NPI assigned

Apr 3, 2007

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 identifiers 2

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Jefferson Hospital Association, Inc

  • Rural Health Clinic/Center
  • Crossett, AR
  • NPI 1225799646
  NPD (past)
• Norton Community Physician Services LLC

  • Internal Medicine Physician
  • Pennington Gap, VA
  • NPI 1841098175
  NPD (past)
• Norton Community Physician Services LLC

  • Internal Medicine Physician
  • Norton, VA
  • NPI 1861674160

  Pulmonary Disease

  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1932220902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 E JACKSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013119",
            "telephone_number": "870-972-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E JACKSON AVE",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724013119",
            "telephone_number": "870-972-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFORE",
        "first_name": "KATIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AR",
            "license": "E4912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "0101245807",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932220902",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Declerk
• Amanda Ann Deel, D.O.
• Mickey Brian Deel, D.O.
• Amanda N Dees, LPN
• Kerri Dees, LPN
• Sarah Katherine Defries, LCSW
• Russell D Degges, M.D.
• Aimee Lashay Dejournett, COTA/L
• Richard Douglas Dekok, PT
• Ryan Delabar

• Pulmonary Disease Physician in Jonesboro, AR
• Providers in Jonesboro, AR by specialty
• Pulmonary Disease Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2011; 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.