Kathryn Mary Zoumberis, RN, CDE

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

08723574 Issued in FL

Practice address

3625 University Blvd S
Jacksonville, FL 32216-4207

Phone

(904) 702-1541

Fax

(904) 702-1831

NPI assigned

Aug 30, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Miss Kathryn Mary Dwyer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1942728902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 MANCHESTER CT N",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322595237",
            "telephone_number": "904-610-5306",
            "fax_number": "904-702-1831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164207",
            "telephone_number": "904-702-1541",
            "fax_number": "904-702-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZOUMBERIS",
        "first_name": "KATHRYN",
        "middle_name": "MARY",
        "name_prefix": "Mrs.",
        "credential": "RN, CDE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN933002",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "FL",
            "license": "RN933002",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "FL",
            "license": "08723574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "DWYER",
            "middle_name": "MARY",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Zorita Koenig Home Care, Inc
• Elizabeth Veronica Zorovich, MD
• Julian Josue Zorrilla, D.O.
• Kayla Ryan Zorrilla, D.O
• Ragab Zoubi, MD, FCS, MMED
• Erin Michelle Zovath, D.C.
• Abba Zubair, MD
• Sarah Zuber
• Eric Cameron Zuberi, MD
• Lara Z Zuberi, MD

• Diabetes Educator Registered Nurse in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Diabetes Educator Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.