Kristyne Jackson

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34009745A Issued in IN

Practice address

2020 Brown St
Anderson, IN 46016-4218

Phone

(317) 574-1254

Fax

(317) 674-0060

NPI assigned

Nov 8, 2015

Last updated

Sep 30, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Krissy Whiteley Other name

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1992781470
  Medicare reassignment NPD
• Centerstone of Indiana, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bloomington, IN
  • NPI 1972320224
  NPD

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

{
    "created_epoch": "1446940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1063885333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "697 PRO MED LN",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460325323",
            "telephone_number": "317-574-1254",
            "fax_number": "317-674-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 BROWN ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164218",
            "telephone_number": "317-574-1254",
            "fax_number": "317-674-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "KRISTYNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-08",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34009745A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISSY",
            "last_name": "WHITELEY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Alex Clayton Irwin, AG-ACNP
• Olivia Isaacs
• J M Holding Group Inc (Chiromed Anderson)
• J. C. Hoover & Associates, Inc.
• Amy J Jackson, NP
• James E Moneyhun MD Medical Corporation
• James S Milligan MD Inc (Central Indiana Otolaryngology)
• Kendra Rae Janney
• Julianne Jarrell, DEVELOPMENTAL THERAP
• Jason C. Sims DDS, P.C.

• Clinical Social Worker in Anderson, IN
• Providers in Anderson, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; 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.