Individual provider Active NPI

Kristina Ann Tyndall, APRN

  • Acute Care Nurse Practitioner
  • Lincoln, NE
National Provider Identifier
1124116504
Registry record updated Dec 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
110738 Issued in NE
Practice address
3901 Pine Lake Rd
Suite 120
Lincoln, NE 68516-5497
Phone
(402) 420-1212
Fax
(402) 328-0961
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 110738 NE Primary

Addresses

Primary practice location

3901 Pine Lake Rd
Suite 120
Lincoln, NE 68516-5497

Mailing address

3901 Pine Lake Rd
Suite 120
Lincoln, NE 68516-5497
Phone (402) 420-1212

Other identifiers 2

IdentifierTypeStateIssuer
47052796712MedicaidNE
01942OtherNEBLUE SHIELD OF NEBRASKA

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)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230595200000",
    "number": "1124116504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 PINE LAKE RD",
            "address_2": "SUITE 120",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165497",
            "telephone_number": "402-420-1212",
            "fax_number": "402-328-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 PINE LAKE RD",
            "address_2": "SUITE 120",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165497",
            "telephone_number": "402-420-1212",
            "fax_number": "402-328-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYNDALL",
        "first_name": "KRISTINA",
        "middle_name": "ANN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NE",
            "license": "110738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47052796712",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF NEBRASKA",
            "identifier": "01942",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2008; 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.