Individual provider Active NPI

Karin Marie Krebs

  • School Registered Nurse
  • Bay Shore, NY
National Provider Identifier
1104313048
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
567206-1 Issued in NY
Practice address
775 Wisconsin Ave
Bay Shore, NY 11706-2336
Phone
(631) 434-2583
NPI assigned
Apr 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 567206-1 NY Primary

Addresses

Primary practice location

775 Wisconsin Ave
Bay Shore, NY 11706-2336

Mailing address

52 3Rd Ave
Brentwood, NY 11717-4651
Phone (631) 434-2583

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

State licenses

LicenseStateTypeSpecialty
567206-1NYMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523923200000",
    "number": "1104313048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 3RD AVE",
            "city": "BRENTWOOD",
            "state": "NY",
            "postal_code": "117174651",
            "telephone_number": "631-434-2583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 WISCONSIN AVE",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117062336",
            "telephone_number": "631-434-2583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREBS",
        "first_name": "KARIN",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-17",
        "last_updated": "2018-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "567206-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.