Individual provider Active NPI

Krista Melody Boone, LMSW

  • Community Health Worker
  • Fairbanks, AK
National Provider Identifier
1104509447
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
Practice address
399 Helmericks Ave
Fairbanks, AK 99701-3180
Phone
(907) 450-3400
NPI assigned
Aug 11, 2023
Last updated
Jul 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X NU Primary

Addresses

Primary practice location

399 Helmericks Ave
Fairbanks, AK 99701-3180

Mailing address

315 Wendell Ave
Fairbanks, AK 99701-4837
Phone (907) 450-3400

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

NPI Registry JSON

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

{
    "created_epoch": "1691712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1104509447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 WENDELL AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014837",
            "telephone_number": "907-450-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 HELMERICKS AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013180",
            "telephone_number": "907-450-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOONE",
        "first_name": "KRISTA",
        "middle_name": "MELODY",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-11",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; 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.