Active NPI
Kristin Kay Johnston, BS BC-HIS
- Specialist
- Grand Haven, MI
National Provider Identifier
1013996958
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 3501003169
- Practice address
- 1101 Columbus Ave
Grand Haven, MI 49417-1556 - Phone
- (616) 847-3144
- Fax
- (616) 847-8416
- NPI assigned
- Jan 10, 2006
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 3501003169 | MI | Primary |
Addresses
Primary practice location
1101 Columbus Ave
Grand Haven, MI 49417-1556
Mailing address
1101 Columbus Ave
Grand Haven, MI 49417-1556
Phone (616) 847-3144
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 904379248 | Medicaid | MI | |
| 904804496 | Medicaid | MI | |
| 540G003350 | Other | MI | BCBS ID |
| 7312319 | Other | MI | AETNA ID |
| 043596178 | Other | MI | PPOM ID |
| 4379248 | Medicaid | MI | |
| 043596178 | Other | MI | PRIORITY HEALTH ID |
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3501003169 | MI | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718323200000",
"number": "1013996958",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 COLUMBUS AVE",
"city": "GRAND HAVEN",
"state": "MI",
"postal_code": "494171556",
"telephone_number": "616-847-3144",
"fax_number": "616-847-8416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 COLUMBUS AVE",
"city": "GRAND HAVEN",
"state": "MI",
"postal_code": "494171556",
"telephone_number": "616-847-3144",
"fax_number": "616-847-8416"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "KRISTIN",
"middle_name": "KAY",
"name_prefix": "Ms.",
"credential": "BS BC-HIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-10",
"last_updated": "2024-06-14",
"certification_date": "2024-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MI",
"license": "3501003169",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "904379248",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "904804496",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS ID",
"identifier": "540G003350",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA ID",
"identifier": "7312319",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PPOM ID",
"identifier": "043596178",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4379248",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIORITY HEALTH ID",
"identifier": "043596178",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Haven, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.