Individual provider Active NPI

Kristin M Gardner, RN

  • Registered Nurse
  • Bristol, CT
National Provider Identifier
1144684580
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
113270 Issued in CT
Practice address
10 N Main St
Bristol, CT 06010-8122
Phone
(860) 584-6555
Fax
(860) 584-6568
NPI assigned
Apr 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 113270 CT Primary

Addresses

Primary practice location

10 N Main St
Bristol, CT 06010-8122

Mailing address

10 N Main St
Bristol, CT 06010-8122
Phone (860) 584-6555

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
113270CTMDRegistered Nurse

Interoperability endpoints

  • Direct secure messaging: kristin.gardner.p1@direct.wheelerclinic.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1460419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1144684580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060108122",
            "telephone_number": "860-584-6555",
            "fax_number": "860-584-6568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 N MAIN ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060108122",
            "telephone_number": "860-584-6555",
            "fax_number": "860-584-6568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "KRISTIN",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-12",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "113270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2016; 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.