Individual provider Active NPI

Kristin O'Donnell, D.N.P, C.R.N.P.

  • Nurse Practitioner
  • Ashland, PA
National Provider Identifier
1104094291
Registry record updated Jun 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP009671 Issued in PA
Practice address
530 Centre St
Ashland, PA 17921-1330
Phone
(570) 645-1670
NPI assigned
Feb 12, 2008
Last updated
Jun 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP009671 PA Primary

Addresses

Primary practice location

530 Centre St
Ashland, PA 17921-1330

Mailing address

530 Centre St
Ashland, PA 17921-1330
Phone (570) 645-1670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090611000088 PA Practitioner - Nurse Practitioner 0042360117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Physician Group IncGroup PAC ID 6709798333, 2,161 clinicians

Practice addresses (Care Compare)

530 Centre St
Ashland, PA 17921-1330
Phone (570) 645-1670

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.13 of 100Reported as apm
Quality
82.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP009671PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
St. Luke's Physician Group, Inc. CurrentSince Jan 2, 2018 Accepting new patients
St. Luke's Physician Group, Inc. Current Accepting new patients
St Luke's Physician Group Inc CurrentSince Jan 2, 2018 Accepting new patients
St. Luke's Physician Group, Inc. Past Accepting new patients
Lehigh Valley Physician Group Nurse Practitioner Past Accepting new patients

Locations

530 W Center St
Ashland, PA 17921
Phone (570) 645-1670

4311 Easton Ave
Bethlehem, PA 18020
Phone (610) 954-3600

Organizations & group practices 5

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782000000000",
    "number": "1104094291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 CENTRE ST",
            "city": "ASHLAND",
            "state": "PA",
            "postal_code": "179211330",
            "telephone_number": "570-645-1670",
            "fax_number": "570-645-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 CENTRE ST",
            "city": "ASHLAND",
            "state": "PA",
            "postal_code": "179211330",
            "telephone_number": "570-645-1670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DONNELL",
        "first_name": "KRISTIN",
        "credential": "D.N.P, C.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-12",
        "last_updated": "2026-06-21",
        "certification_date": "2026-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP009671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashland, PA

Sources for this page

Verify at the official NPI Registry.