Individual provider Active NPI

Kristy Annlyn Knupke, RN

  • Case Management Registered Nurse
  • Waltham, MA
National Provider Identifier
1093545212
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
RN27-1928 Issued in OH
Practice address
221 Crescent St
Waltham, MA 02453-3475
Phone
(800) 338-6833
NPI assigned
Aug 2, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X RN27-1928 OH Primary

Addresses

Primary practice location

221 Crescent St
Waltham, MA 02453-3475

Mailing address

15942 Albion Rd
Strongsville, OH 44136-3655
Phone (216) 262-6300

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
RN27-1928OHMDCase Management Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1722556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1093545212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15942 ALBION RD",
            "city": "STRONGSVILLE",
            "state": "OH",
            "postal_code": "441363655",
            "telephone_number": "216-262-6300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 CRESCENT ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024533475",
            "telephone_number": "800-338-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUPKE",
        "first_name": "KRISTY",
        "middle_name": "ANNLYN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-02",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "OH",
            "license": "RN27-1928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; 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.