Individual provider Active NPI

Kristin Hammoud, CNS/NP

  • Psychiatric/Mental Health Registered Nurse
  • Indianapolis, IN
National Provider Identifier
1164433470
Registry record updated Feb 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X
License
70000168A Issued in IN
Practice address
1481 W 10TH St
Indianapolis, IN 46202-2803
Phone
(317) 988-2388
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 71001910A IN
Psychiatric/Mental Health Registered Nurse 163WP0808X 70000168A IN Primary

Addresses

Primary practice location

1481 W 10TH St
Indianapolis, IN 46202-2803

Mailing address

16108 Cog Hill Dr
Northville, MI 48168-8624
Phone (734) 404-5306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 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

Enrollment IDStateProvider typePAC IDDetails
I20100123000139 MI Practitioner - Certified Clinical Nurse Specialist (CNS) 3971645391 Reassigns benefits to 1 organization
I20240125002882 MI Practitioner - Nurse Practitioner 3971645391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Victor M. Cruz MD, P.C.Group PAC ID 3375604952, 29 clinicians

Practice addresses (Care Compare)

16108 Cog Hill Dr
Northville, MI 48168-8624
Phone (317) 437-5850

17177 N Laurel Park Dr
Suite 131
Livonia, MI 48152-3952
Phone (734) 462-3210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71001910AINMDGeneral Practice Registered Nurse
70000168AINMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
KH Mental Health Wellness PLLC CurrentSince Jan 2, 2024 Accepting new patients
Victor M. Cruz MD, P.C. CurrentSince Jul 1, 2015 Accepting new patients

Locations

17177 Laurel Dr
Ste 131
Livonia, MI 48152
Phone (313) 462-3210

17177 N Laurel Park Dr
Ste 131
Livonia, MI 48152
Phone (734) 462-3210

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235433600000",
    "number": "1164433470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16108 COG HILL DR",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481688624",
            "telephone_number": "734-404-5306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1481 W 10TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462022803",
            "telephone_number": "317-988-2388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMOUD",
        "first_name": "KRISTIN",
        "name_prefix": "Mrs.",
        "credential": "CNS/NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2009-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "IN",
            "license": "71001910A",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "IN",
            "license": "70000168A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.