Individual provider Active NPI

Kristin Ann Nostrom, PHARMD

  • Pharmacist
  • Emmetsburg, IA
National Provider Identifier
1174850879
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
21080 Issued in IA
Practice address
2216 Main St
Emmetsburg, IA 50536-2447
Phone
(712) 852-2886
Fax
(712) 852-2534
NPI assigned
Nov 17, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 21080 IA Primary

Addresses

Primary practice location

2216 Main St
Emmetsburg, IA 50536-2447

Mailing address

2216 Main St
Emmetsburg, IA 50536-2447
Phone (712) 852-2886

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
21080IAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1258416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1174850879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 MAIN ST",
            "city": "EMMETSBURG",
            "state": "IA",
            "postal_code": "505362447",
            "telephone_number": "712-852-2886",
            "fax_number": "712-852-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 MAIN ST",
            "city": "EMMETSBURG",
            "state": "IA",
            "postal_code": "505362447",
            "telephone_number": "712-852-2886",
            "fax_number": "712-852-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOSTROM",
        "first_name": "KRISTIN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-17",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IA",
            "license": "21080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emmetsburg, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; 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.