Active NPI
Kristyn Beth Elliott, RN
- Community Health Registered Nurse
- Holyoke, MA
National Provider Identifier
1104176692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Registered Nurse
- License
- RN2260547
- Practice address
- 420 Maple St
Holyoke, MA 01040 - Phone
- (413) 420-2200
- NPI assigned
- Sep 12, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Registered Nurse | 163WC1500X | RN2260547 | MA | Primary |
Addresses
Primary practice location
420 Maple St
Holyoke, MA 01040
Mailing address
420 Maple St
Holyoke, MA 01040
Phone (413) 420-2200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1300237 | Other | MA | MASS HEALTH |
Other names 1
- Kristyn Beth McLellan
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN2260547 | MA | MD | Community Health Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347408000000",
"number": "1104176692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 MAPLE ST",
"city": "HOLYOKE",
"state": "MA",
"postal_code": "01040",
"telephone_number": "413-420-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 MAPLE ST",
"city": "HOLYOKE",
"state": "MA",
"postal_code": "01040",
"telephone_number": "413-420-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLIOTT",
"first_name": "KRISTYN",
"middle_name": "BETH",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-12",
"last_updated": "2012-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "163WC1500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Community Health",
"state": "MA",
"license": "RN2260547",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASS HEALTH",
"identifier": "1300237",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTYN",
"last_name": "MCLELLAN",
"middle_name": "BETH",
"credential": "RN",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Holyoke, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.