Kristian Anderson, AGACNP-BC

Primary specialty

Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X

License

14649-33 Issued in WI

Practice address

401 E Industrial Dr Unit 627
Hartland, WI 53029-0820

Phone

(414) 850-7586

NPI assigned

Aug 21, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Midwest Critical Care SC

  • Critical Care Medicine (Internal Medicine) Physician
  • Mount Pleasant, WI
  • NPI 1093425647
  Medicare reassignment NPD

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

{
    "created_epoch": "1692576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1053195099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3581 S 51ST ST",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532201545",
            "telephone_number": "715-370-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E INDUSTRIAL DR UNIT 627",
            "city": "HARTLAND",
            "state": "WI",
            "postal_code": "530290820",
            "telephone_number": "414-850-7586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KRISTIAN",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-21",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "WI",
            "license": "241106-30",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "WI",
            "license": "14649-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aegis Group Practice LLC
• Ahp 002 LLC
• Alliance Counseling Center LLC
• Alta Soma Physical Therapy
• Jonah Mical Anderson, LPC, MA, CSAT
• Kevin J. Arnold, D.O.
• Arrowhead Union High School
• Arrowhead Union High School
• Ascendent Health Partners
• Aurora Health Care Ventures Inc.

• Critical Care Medicine Nurse Practitioner in Hartland, WI
• Providers in Hartland, WI by specialty
• Critical Care Medicine Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.