Khrystyna Antonova, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

7317 Issued in MN

Practice address

15552 57TH PL N
Plymouth, MN 55446-3737

Phone

(612) 481-1842

NPI assigned

Dec 3, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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

• Metropolitan Pediatric Specialists, P.a.

  • Clinic/Center
  • Edina, MN
  • NPI 1558459206
  NPD (past)
• Partners in Pediatrics, LTD.

  • Pediatrics Physician
  • Maple Grove, MN
  • NPI 1487604104
  NPD (past)

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1033877378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15552 57TH PL N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463737",
            "telephone_number": "612-481-1842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15552 57TH PL N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463737",
            "telephone_number": "612-481-1842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONOVA",
        "first_name": "KHRYSTYNA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-03",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "7317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Byer PHD Licensed Psychologist PLLC
• Anne Silverman Consulting LLC
• Jennifer Lyn Annunziata, OCCUPATIONAL THERAPI
• Karen Gail Anonsen, CRNA
• Heather Marie Anton, MA, LPCC
• Blessing Anyanwu, RN
• Arbor Audiology LLC
• Archangel Transportation Inc.
• Ark Counseling
• Arnesen & Herbert DDS

• All providers in Plymouth, MN
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.