Individual provider Active NPI

Katharine C Vachon, N. P.

  • Acute Care Nurse Practitioner
  • Clarksville, TN
National Provider Identifier
1992725105
Registry record updated Apr 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APN11796 Issued in TN
Practice address
291 Clear Sky CT
Ste B
Clarksville, TN 37043-5951
Phone
(931) 802-6058
Fax
(931) 802-6059
NPI assigned
Jul 20, 2006
Last updated
Apr 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APN11796 TN Primary

Addresses

Primary practice location

291 Clear Sky CT
Ste B
Clarksville, TN 37043-5951

Mailing address

291 Clear Sky CT
Ste B
Clarksville, TN 37043-5951
Phone (931) 802-6058

Other identifiers 1

IdentifierTypeStateIssuer
1517918MedicaidTN

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
I20060103000592 TN Practitioner - Nurse Practitioner 6800818931

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN11796TNMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nebben Chiropractic Center Past Accepting new patients

Organizations & group practices 2

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461715200000",
    "number": "1992725105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 CLEAR SKY CT",
            "address_2": "STE B",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370435951",
            "telephone_number": "931-802-6058",
            "fax_number": "931-802-6059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 CLEAR SKY CT",
            "address_2": "STE B",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370435951",
            "telephone_number": "931-802-6058",
            "fax_number": "931-802-6059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACHON",
        "first_name": "KATHARINE",
        "middle_name": "C",
        "credential": "N. P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2016-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "APN11796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1517918",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.