Individual provider Active NPI

Kristin Denice Coble, AGACNP-BC, FNP-BC

  • Acute Care Nurse Practitioner
  • Lansing, MI
National Provider Identifier
1154058923
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704314544 Issued in MI
Practice address
1540 Lake Lansing Rd Ste 203
Lansing, MI 48912-3757
Phone
(517) 913-6711
Fax
(517) 913-6712
NPI assigned
Aug 2, 2022
Last updated
Mar 12, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704314544 MI Primary
Family Nurse Practitioner 363LF0000X 4704314544 MI

Addresses

Primary practice location

1540 Lake Lansing Rd Ste 203
Lansing, MI 48912-3757

Mailing address

3239 Pickwick PL
Lansing, MI 48917-1719
Phone (708) 289-1878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220816003505 MI Practitioner - Nurse Practitioner 2163805672 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of South Alabama College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Physician Group PCGroup PAC ID 0648277830, 11 clinicians

Practice addresses (Care Compare)

1200 E Michigan Ave
Suite 340 University of Michigan Health SP
Lansing, MI 48912-1894
Phone (517) 364-5930

1540 Lake Lansing Rd
Suite 203
Lansing, MI 48912-3757
Phone (517) 913-6711

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704314544MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association CurrentSince May 31, 2025 Accepting new patients
Vituity - Michigan Hospitalists PC CurrentSince Aug 18, 2022 Accepting new patients
Theoria Medical CurrentSince Nov 18, 2024 Accepting new patients
Edward W. Sparrow Hospital Association CurrentSince May 31, 2025 Accepting new patients
Signify Health Medical Associates, PLLC CurrentSince Sep 7, 2024 Accepting new patients
Legacy Physician Group, P.C. CurrentSince May 12, 2025 Accepting new patients
Edward W. Sparrow Hospital Association Current Accepting new patients
Edward W. Sparrow Hospital Association Past Accepting new patients
Wellbridge of Clarkston, LLC Past Accepting new patients
Lansing Urgent Care, PLC PastSince Sep 7, 2023 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

8175 Reliable Pkwy
Chicago, IL 60686

406 E Elm St
Carson City, MI 48811
Phone (517) 584-3131

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

1200 E Michigan Ave
Ste 340
Lansing, MI 48912
Phone (517) 364-5930

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1215 E Michigan Ave
#8W
Lansing, MI 48912
Phone (517) 364-2614

1540 Lake Lansing Rd
Ste 203
Lansing, MI 48912
Phone (517) 913-3855

9480 E M 21
Ovid, MI 48866
Phone (989) 834-0000

13 N Washington St
Ypsilanti, MI 48197
Phone (734) 329-4620

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1154058923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3239 PICKWICK PL",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489171719",
            "telephone_number": "708-289-1878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 LAKE LANSING RD STE 203",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489123757",
            "telephone_number": "517-913-6711",
            "fax_number": "517-913-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBLE",
        "first_name": "KRISTIN",
        "middle_name": "DENICE",
        "credential": "AGACNP-BC, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-02",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704314544",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704314544",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.