MRS. KATIE JO KMIECIK (NPI# 1629461280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629461280 |
| Entity Type | Individual |
| Full Name | MRS. KATIE JO KMIECIK |
| Other Name | MISS KATIE JO GAFFNEY |
| Credential | FNP |
| Practice Address |
2510 Bellevue Medical Center Dr Ste 200 Bellevue NE 68123 |
| Mailing Address |
988102 Nebraska Medical Ctr Omaha NE 68198-8102 |
| Practice Telephone | 4025952275 |
| Practice Fax Number | 4025951970 |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2018-08-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 111781 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
111781 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2510 BELLEVUE MEDICAL CENTER DR STE 200 |
| City | BELLEVUE |
| State | NE |
| Zip Code | 68123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073599890 | Jeremy C King | Family Medicine | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2005-12-22 |
| 1750996831 | Hillary Suzanne Stark | Nurse Practitioner | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2020-09-15 |
| 1104449149 | Holly Lynn Groteluschen | Student in an Organized Health Care Education/Training Program | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2020-05-26 |
| 1306484944 | Kayla Renee Hergert | Nurse Practitioner | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2019-12-13 |
| 1891342671 | Nancy L Childe | Nurse Practitioner | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2019-08-26 |
| 1295203701 | Allison Cox | Physician Assistant | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2018-11-02 |
| 1255817367 | Christabel Orobosa Alphonso | Nurse Practitioner | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2018-07-12 |
| 1770075129 | Jamie Michelle Shaw | Nurse Practitioner | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2018-06-01 |
| 1952815920 | Alix Sandbothe | Nurse Practitioner | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2017-11-28 |
| 1639555279 | Shelley C Booth | Nurse Practitioner | 2510 Bellevue Medical Center Dr Ste 200, Bellevue, NE 68123-1520 | 2015-08-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482227 | Gloria Pettigrew-fletcher | Community Health Worker | 12432 A 36th St, C20, Bellevue, NE 68123 | 2020-03-13 |
| 1225480676 | Heidi Jean Mccoy | Dentist | 2110 Towne Centre Drive, Bellevue, NE 68123 | 2016-07-11 |
| 1538557442 | Mariam Abdelghany I | Physician Assistant | 2500 Bellevue Medical Center Drive, Bellevue, NE 68123 | 2014-12-30 |
| 1205243367 | Sara Johnson | Pharmacist | 3614 Twin Creeks Drive, Bellevue, NE 68123 | 2014-07-21 |
| 1174826747 | Francine Amy Drummond | Dentist | 1701 Independence Lane #22, Bellevue, NE 68123 | 2010-12-21 |
| 1053509588 | Dunlow Orthodontics, P.C. | Dentist | 2219 Capehart Road, Suite 102, Bellevue, NE 68123 | 2007-10-10 |
| 1801911870 | Michelle Lynn Gaeth | Dentist | 11536 S. 31st St., Bellevue, NE 68123 | 2007-03-20 |
| 1386789832 | Mary Monique Rotert | Psychologist | 3308 Samson Way Road, Suite 211, Bellevue, NE 68123 | 2007-02-21 |
| 1316084098 | Kevin B Jones | Family Medicine | 3308 Samson Way Ste 102, Bellevue, NE 68123 | 2007-01-31 |
| 1467529727 | Nebraska Medical Center | Pharmacy | 2510 Bellevue Medical Center Drive, Suite 100, Bellevue, NE 68123 | 2006-11-29 |
| Find all providers in zip 68123 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073111902 | Hailey Marie Baker | Nurse Practitioner | 3055 112th Ave Ne Ste 201, Bellevue, WA 98004-2091 | 2020-10-13 |
| 1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
| 1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
| 1841598448 | Lifecare Family Medicine of Bellevue, PC | Nurse Practitioner | 2510 Bellevue Medical Center Dr # 145a, Bellevue, NE 68123-1520 | 2011-03-05 |
| 1194868406 | Sherry Aanstad | Nurse Practitioner | 117 Ash St, Bellevue, ID 83313-5226 | 2007-02-15 |
| 1245394485 | Christopher Craig | Nurse Practitioner | 16320 Se 15th St, Bellevue, WA 98008-5102 | 2006-12-21 |
| 1679634588 | Douglas R. Penington | Nurse Practitioner | 12717 S 28th Ave, Bellevue, NE 68123-3232 | 2006-12-13 |
| 1023029394 | Kathryn S Deane | Nurse Practitioner | 1715 114th Ave Se, Suite 110, Bellevue, WA 98004-6945 | 2006-08-11 |
| 1245288869 | Lynne B Vigesaa | Nurse Practitioner | 1260 116th Avenue Ne, Suite 100, Bellevue, WA 98004 | 2006-05-05 |
| 1518934199 | Marcia Smith Gordon | Nurse Practitioner | 1632 116th Ave Ne, Suite B, Bellevue, WA 98004-3035 | 2006-03-02 |
| Find all providers in BELLEVUE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.