Kristen Pommenville, MSN. RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

54726201 Issued in NY

Practice address

100 Saratoga Village Blvd Ste 9
Ballston Spa, NY 12020-3703

Phone

(518) 886-8251

Fax

(518) 400-1069

NPI assigned

Jun 10, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Adirondack Registered Professional Nursing Services PLLC

  • Nursing Care Agency
  • Malta, NY
  • NPI 1023240454
  NPD Authorized official

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654819200000",
    "number": "1124757406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2740",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120208740",
            "telephone_number": "518-886-8251",
            "fax_number": "518-400-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SARATOGA VILLAGE BLVD STE 9",
            "city": "BALLSTON SPA",
            "state": "NY",
            "postal_code": "120203703",
            "telephone_number": "518-886-8251",
            "fax_number": "518-400-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMMENVILLE",
        "first_name": "KRISTEN",
        "credential": "MSN. RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-10",
        "last_updated": "2022-06-10",
        "certification_date": "2022-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "54726201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Physical Therapy Associates of Schenectady, PC
• Todd Michael Pikor, R.PH
• Alexander Pisanello, DPT
• Shirley Podkulski, RN
• Anthony D Pomato, D.D.S.
• Michelle Marie Powers
• Thomas John Pray, DDS
• Quality Care-USA, Inc.
• Michael Matthew Quartararo, D.C
• Gerald Vincent Quinnan III, LMSW

• Registered Nurse in Ballston Spa, NY
• Providers in Ballston Spa, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2022; 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.