Individual provider Active NPI

Kristie Cole, R.N.

  • Registered Nurse
  • Mission Viejo, CA
National Provider Identifier
1053689968
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
732011 Issued in CA
Practice address
28201 Marguerite Pkwy
#13
Mission Viejo, CA 92692-3719
Phone
(949) 364-3928
Fax
(949) 364-2297
NPI assigned
Dec 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 732011 CA Primary

Addresses

Primary practice location

28201 Marguerite Pkwy
#13
Mission Viejo, CA 92692-3719

Mailing address

28201 Marguerite Pkwy
#13
Mission Viejo, CA 92692-3719
Phone (949) 364-3928

Other identifiers 1

IdentifierTypeStateIssuer
33-0150193OtherCAMEDI-CAL

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
732011CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1323129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1053689968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28201 MARGUERITE PKWY",
            "address_2": "#13",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926923719",
            "telephone_number": "949-364-3928",
            "fax_number": "949-364-2297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28201 MARGUERITE PKWY",
            "address_2": "#13",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926923719",
            "telephone_number": "949-364-3928",
            "fax_number": "949-364-2297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "KRISTIE",
        "credential": "R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-06",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "732011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "33-0150193",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.