Kristin Marie O'Brien, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

19019 Issued in SC

Practice address

370 South Pike West
Sumter, SC 29150-2664

Phone

(803) 774-7337

Fax

(803) 774-4629

NPI assigned

Dec 18, 2012

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

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

{
    "created_epoch": "1355788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543276800000",
    "number": "1083950174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 SOUTH PIKE WEST",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502664",
            "telephone_number": "803-774-7337",
            "fax_number": "803-774-4629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 SOUTH PIKE WEST",
            "city": "SUMTER",
            "state": "SC",
            "postal_code": "291502664",
            "telephone_number": "803-774-7337",
            "fax_number": "803-774-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-18",
        "last_updated": "2018-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "19019",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "204188",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kenechukwu O. Ntukogu, M.D.
• Shannon Kathleen O'Connor-Schlichter
• Oak Hollow of Sumter Rehabilitation Center LLC
• Katelynn I Oakley, BCABA
• Ohio Valley Physicians, Inc
• Ohio Valley Physicians, Inc

• Pediatric Nurse Practitioner in Sumter, SC
• Providers in Sumter, SC by specialty
• Pediatric Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; 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.