Active NPI
Kristine Johnston
- Licensed Practical Nurse
- Grand Rapids, MI
National Provider Identifier
1194100412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- J523478040704
- Practice address
- 325 National Ave NW
Apt 6
Grand Rapids, MI 49504-5594 - Phone
- (616) 589-8778
- NPI assigned
- Jul 28, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | J523478040704 | MI | Primary |
Addresses
Primary practice location
325 National Ave NW
Apt 6
Grand Rapids, MI 49504-5594
Mailing address
325 National Ave NW
Apt 6
Grand Rapids, MI 49504-5594
Phone (616) 589-8778
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| J523478040704 | MI | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438041600000",
"number": "1194100412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 NATIONAL AVE NW",
"address_2": "APT 6",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495045594",
"telephone_number": "616-589-8778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 NATIONAL AVE NW",
"address_2": "APT 6",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495045594",
"telephone_number": "616-589-8778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "KRISTINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-28",
"last_updated": "2015-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "MI",
"license": "J523478040704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.