Individual provider Active NPI

Kate Loftin Cepparulo, N.P.

  • Family Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1972875516
Registry record updated Nov 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16414 Issued in TN
Practice address
620 Skyline Dr
Jackson, TN 38301-3923
Phone
(731) 541-5000
Fax
(731) 541-4922
NPI assigned
Jan 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 16414 TN Primary

Addresses

Primary practice location

620 Skyline Dr
Jackson, TN 38301-3923

Mailing address

145 Castleton CV
Medina, TN 38355-6870

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20120229000464 TN Practitioner - Nurse Practitioner 2668630161 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
16414TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Care Facilities PC CurrentSince Feb 15, 2012 Accepting new patients

Locations

650 Nuckolls Rd
Bolivar, TN 38008
Phone (731) 541-6834

175 Hospital Dr
Camden, TN 38320
Phone (731) 584-6135

367 Hospital Blvd
Jackson, TN 38305
Phone (731) 661-2000

620 Skyline Dr
Jackson, TN 38301
Phone (731) 541-4923

161 Mount Pelia Rd
Martin, TN 38237
Phone (731) 587-4261

4039 Highland St
Ste 1
Milan, TN 38358
Phone (731) 723-3668

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1327708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352764800000",
    "number": "1972875516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 CASTLETON CV",
            "city": "MEDINA",
            "state": "TN",
            "postal_code": "383556870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SKYLINE DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013923",
            "telephone_number": "731-541-5000",
            "fax_number": "731-541-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEPPARULO",
        "first_name": "KATE",
        "middle_name": "LOFTIN",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-28",
        "last_updated": "2012-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "16414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.