Individual provider Active NPI

Christianne C Kisner, NP

  • Nurse Practitioner
  • Torrance, CA
National Provider Identifier
1104247683
Registry record updated Sep 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
23636 Issued in CA
Practice address
2841 Lomita Blvd.
Suite 220
Torrance, CA 90505
Phone
(310) 326-8600
NPI assigned
Dec 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2017

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 23636 CA Primary

Addresses

Primary practice location

2841 Lomita Blvd.
Suite 220
Torrance, CA 90505

Mailing address

2841 Lomita Blvd.
Suite 220
Torrance, CA 90505
Phone (310) 326-8600

Other names 1

  • Christianne C Delamerced Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20141208000015 CA Practitioner - Nurse Practitioner 6901128735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Torrance Health Association IncGroup PAC ID 1355302134, 298 clinicians

Practice addresses (Care Compare)

2900 Lomita Blvd
Torrance, CA 90505-5102
Phone (310) 257-7260

Hospital & facility affiliations

  • Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23636CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Torrance Health Association Inc CurrentSince Dec 1, 2014 Accepting new patients
Optum Palos Verdes PastSince Jan 5, 2009 Accepting new patients

Locations

514 N Prospect Ave
Fl 4
Redondo Beach, CA 90277
Phone (310) 750-3300

2900 Lomita Blvd
Torrance, CA 90505
Phone (310) 257-7260

2841 Lomita Blvd
Ste 220
Torrance, CA 90505
Phone (310) 326-8600

23326 Hawthorne Blvd
Ste 200
Torrance, CA 90505
Phone (310) 257-7205

2841 Lomita Blvd
Ste 315
Torrance, CA 90505
Phone (310) 517-4785

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1388361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505347200000",
    "number": "1104247683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2841 LOMITA BLVD.",
            "address_2": "SUITE 220",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90505",
            "telephone_number": "310-326-8600",
            "fax_number": "310-326-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2841 LOMITA BLVD.",
            "address_2": "SUITE 220",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "90505",
            "telephone_number": "310-326-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISNER",
        "first_name": "CHRISTIANNE",
        "middle_name": "C",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-30",
        "last_updated": "2017-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "23636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTIANNE",
            "last_name": "DELAMERCED",
            "middle_name": "C",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.