Kristen Scott Forstrom, APNP, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704359564 Issued in MI

Practice address

1711 S Stephenson Ave Ste 215
Iron Mountain, MI 49801-3649

Phone

(906) 828-2576

NPI assigned

Jul 19, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Kristen S Weichbrodt Former name

Medicare fee-for-service enrollment

Enrolled in MI, WI2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bellin Memorial Hospital IncGroup PAC ID 8820900749, shared by 10 NPIs, 685 clinicians

St Francis HospitalGroup PAC ID 5991604753, 85 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshfield Medical Center Hospital, Iron Mountain, MI, CCN 231342
• Bellin Memorial Hospital Hospital, Green Bay, WI, CCN 520049
• Osf St Francis Hospital and Medical Group Hospital, Escanaba, MI, CCN 231337

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kforstrom925795@direct.emplifyhealth.org
• Direct secure messaging: kforstrom175021@direct.thedacare.org

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.

• St. Francis Hospital

  • Obstetrics & Gynecology Physician
  • Escanaba, MI
  • NPI 1700828837

  MI

  Medicare reassignment Care Compare group NPD
• Bellin Memorial Hospital Inc

  • Cardiovascular Disease Physician
  • Crystal Falls, MI
  • NPI 1376649509

  MI

  Medicare reassignment NPD
• Bellin Memorial Hospital Inc

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473

  WI

  Medicare reassignment NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527

  MI

  Medicare reassignment NPD
• St Francis Hospital

  • Anatomic Pathology & Clinical Pathology Physician
  • Escanaba, MI
  • NPI 1932206455
  NPD
• St. Francis Hospital

  • Family Medicine Physician
  • Escanaba, MI
  • NPI 1629011622

  Nurse Practitioner

  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390
  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Marinette, WI
  • NPI 1881726529
  NPD
• Bellin Memorial Hospital Inc

  • Family Medicine Physician
  • Brillion, WI
  • NPI 1962464784
  NPD (past)

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

• Dickinson County Healthcare System

  • Critical Access Hospital
  • Iron Mountain, MI
  • NPI 1841188604

  Hospital

  Care Compare affiliation
• St Francis Hospital

  • Critical Access Hospital
  • Escanaba, MI
  • NPI 1922058551

  Hospital

  Care Compare affiliation
• Bellin Memorial Hospital Inc.

  • General Acute Care Hospital
  • Green Bay, WI
  • NPI 1891740585

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634601600000",
    "number": "1164095139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7222",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 S STEPHENSON AVE STE 215",
            "city": "IRON MOUNTAIN",
            "state": "MI",
            "postal_code": "498013649",
            "telephone_number": "906-828-2576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "610 S Lincoln Rd",
            "address_purpose": "LOCATION",
            "city": "Escanaba",
            "state": "MI",
            "postal_code": "498291215",
            "country_code": "US",
            "telephone_number": "906-786-6488",
            "fax_number": "906-786-6409",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "744 S Webster Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013505",
            "country_code": "US",
            "telephone_number": "920-433-3640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORSTROM",
        "first_name": "KRISTEN",
        "middle_name": "SCOTT",
        "credential": "APNP, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "11094-33",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704359564",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704359564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN ACADEMY OF NURSE PRACTITIONERS",
            "identifier": "F06211083",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "WEICHBRODT",
            "middle_name": "S",
            "credential": "APNP,NP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Daniel John Fornetti, DDS
• John Thomas Fornetti, DDS
• Mary Therese Fornetti, MMS PA-C
• Paul J Fornetti, D.D.S.
• Theodore A Fornetti, DDS
• Paige Alyn Fortner, AGACNP-BC
• Nicole Marie Foster Holdwick, LMSW
• Emma Leigh Foster, PA-C
• Amy R Fowler, LCSW
• Kaylie France, LMT

• All providers in Iron Mountain, MI
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.