Active NPI
Kathy Jean Dusthimer, APRN
- Family Nurse Practitioner
- East Moline, IL
National Provider Identifier
1972867273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209008075
- Practice address
- 465 Avenue of the Cities
Suite 140
East Moline, IL 61244-4044 - Phone
- (309) 755-9400
- NPI assigned
- Jul 2, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209008075 | IL | Primary |
Addresses
Primary practice location
465 Avenue of the Cities
Suite 140
East Moline, IL 61244-4044
Mailing address
3722 Forest Rd
Davenport, IA 52807-2347
Phone (563) 355-5418
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341187200000",
"number": "1972867273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3722 FOREST RD",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528072347",
"telephone_number": "563-355-5418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "465 AVENUE OF THE CITIES",
"address_2": "SUITE 140",
"city": "EAST MOLINE",
"state": "IL",
"postal_code": "612444044",
"telephone_number": "309-755-9400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUSTHIMER",
"first_name": "KATHY",
"middle_name": "JEAN",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-02",
"last_updated": "2012-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209008075",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Moline, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.