Individual provider Active NPI

Katrina Lynn Dotterweich

  • Licensed Practical Nurse
  • Kent, OH
National Provider Identifier
1982306197
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
RN.433995 Issued in OH
Practice address
2500 State Route 59 Ste 30
Kent, OH 44240-7105
Phone
(330) 552-4000
Fax
(330) 552-4001
NPI assigned
Mar 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X RN.433995 OH Primary

Addresses

Primary practice location

2500 State Route 59 Ste 30
Kent, OH 44240-7105

Mailing address

2500 State Route 59 Ste 30
Kent, OH 44240-7105
Phone (330) 552-4000

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN.433995OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1982306197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 STATE ROUTE 59 STE 30",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442407105",
            "telephone_number": "330-552-4000",
            "fax_number": "330-552-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 STATE ROUTE 59 STE 30",
            "city": "KENT",
            "state": "OH",
            "postal_code": "442407105",
            "telephone_number": "330-552-4000",
            "fax_number": "330-552-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOTTERWEICH",
        "first_name": "KATRINA",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "RN.433995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.