Individual provider Active NPI

Kristin Virginia Davis, RN

  • Registered Nurse
  • Jbphh, HI
National Provider Identifier
1053619239
Registry record updated Mar 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
543277 Issued in CA
Practice address
480 Central Ave
Attn Medical Staff Services Prof- Rm218
J B P H H, HI 96860-4908
Phone
(808) 471-1866
Fax
(808) 471-0918
NPI assigned
Mar 11, 2011
Last updated
Mar 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 543277 CA Primary
Ambulatory Care Registered Nurse 163WP2201X RN-68819 HI

Addresses

Primary practice location

480 Central Ave
Attn Medical Staff Services Prof- Rm218
J B P H H, HI 96860-4908

Mailing address

480 Central Ave
Attn Medical Staff Services Prof- Rm218
Jbphh, HI 96860-4908
Phone (808) 471-1866

Other names 1

  • Mrs. Kristin Virginia Langen Former name

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
543277CAMDRegistered Nurse
RN-68819HIMDAmbulatory Care Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1299801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299801600000",
    "number": "1053619239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 CENTRAL AVE",
            "address_2": "ATTN MEDICAL STAFF SERVICES PROF- RM218",
            "city": "JBPHH",
            "state": "HI",
            "postal_code": "968604908",
            "telephone_number": "808-471-1866",
            "fax_number": "808-471-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 CENTRAL AVE",
            "address_2": "ATTN MEDICAL STAFF SERVICES PROF- RM218",
            "city": "J B P H H",
            "state": "HI",
            "postal_code": "968604908",
            "telephone_number": "808-471-1866",
            "fax_number": "808-471-0918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "KRISTIN",
        "middle_name": "VIRGINIA",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-11",
        "last_updated": "2011-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "543277",
            "primary": true
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "HI",
            "license": "RN-68819",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "LANGEN",
            "middle_name": "VIRGINIA",
            "prefix": "MRS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jbphh, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; 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.