Individual provider Active NPI

Kryn L Sisco, PMHNP-BC, MPA,BSN RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Lansing, MI
National Provider Identifier
1245296326
Registry record updated Jan 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704152662 Issued in MI
Practice address
812 E Jolly Rd
Ste 216
Lansing, MI 48910-6818
Phone
(517) 346-9554
Fax
(517) 346-8291
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704152662 MI Primary

Addresses

Primary practice location

812 E Jolly Rd
Ste 216
Lansing, MI 48910-6818

Mailing address

101 W Townsend Rd
Saint Johns, MI 48879-9200
Phone (989) 403-6100

Other identifiers 1

IdentifierTypeStateIssuer
1245296326MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL HCS Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220203000156 MI Practitioner - Nurse Practitioner 2769875368 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3600 N Saginaw Rd
Clinton County Medical Center Psych
Midland, MI 48640-2301
Phone (989) 510-7626

Merit-based Incentive Payment System (MIPS)

Final score
97.56 of 100Reported as group
Quality
79.85
Promoting interoperability
100
Improvement activities
40
Cost
78.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704152662MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Downriver Mental Health Clinic PC CurrentSince Sep 8, 2022 Accepting new patients
Family Health Psychiatric & Counseling Center, PC CurrentSince Jul 1, 2023 Accepting new patients
Healthy Transitions LLC CurrentSince Dec 17, 2023 Accepting new patients
Recovery Physicians Network of Michigan Psychiatric/Mental Health CurrentSince Jan 18, 2022 Accepting new patients
Downriver Mental Health Clinic PC CurrentSince Sep 8, 2022 Accepting new patients
Community Mental Health Authority of Clinton Eaton Ingham Counties Past Accepting new patients
Clinton County Medical Center Psychological Services PLLC Psychiatric/Mental Health PastSince Mar 25, 2026 Accepting new patients

Locations

120 E Warwick Dr
Alma, MI 48801
Phone (989) 463-2779

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

1701 Lake Lansing Rd
Ste 120
Lansing, MI 48912
Phone 8104947180 ext. 106

1621 E Broomfield St
Ste A
Mt Pleasant, MI 48858
Phone (989) 400-4588

101 W Townsend Rd
Saint Johns, MI 48879
Phone (989) 403-6022

20500 Eureka Rd
Ste 200
Taylor, MI 48180
Phone (734) 285-8282

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24246/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kryn.sisco.1@24246.direct.athenahealth.com

Organizations & group practices 8

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642982400000",
    "number": "1245296326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W TOWNSEND RD",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488799200",
            "telephone_number": "989-403-6100",
            "fax_number": "989-403-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 E JOLLY RD",
            "address_2": "STE 216",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489106818",
            "telephone_number": "517-346-9554",
            "fax_number": "517-346-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISCO",
        "first_name": "KRYN",
        "middle_name": "L",
        "credential": "PMHNP-BC, MPA,BSN RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2022-01-24",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704152662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245296326",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "HCS",
            "affiliation": "N",
            "endpointDescription": "HCS",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Chart",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "paper chart",
            "address_1": "101 W Townsend Rd",
            "city": "Saint Johns",
            "state": "MI",
            "country_code": "US",
            "postal_code": "488799200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.