Individual provider Active NPI

Kristin Gartner, RN, BSN, IBCLC, RLC

  • Lactation Consultant (Registered Nurse)
  • Jacksonville, FL
National Provider Identifier
1205045572
Registry record updated Sep 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
RN9324555 Issued in FL
Practice address
1539 Parental Home Rd
Jacksonville, FL 32216-3009
Phone
(904) 568-0581
NPI assigned
May 22, 2007
Last updated
Sep 12, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X RN9324555 FL Primary

Addresses

Primary practice location

1539 Parental Home Rd
Jacksonville, FL 32216-3009

Mailing address

1539 Parental Home Rd
Jacksonville, FL 32216-3009
Phone (904) 568-0581

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN9324555FLMDLactation Consultant (Registered Nurse)

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9429/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315785600000",
    "number": "1205045572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1539 PARENTAL HOME RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163009",
            "telephone_number": "904-568-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1539 PARENTAL HOME RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163009",
            "telephone_number": "904-568-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARTNER",
        "first_name": "KRISTIN",
        "credential": "RN, BSN, IBCLC, RLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2011-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "FL",
            "license": "RN9324555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; 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.