Individual provider Active NPI

Kristyn Nicole Junkin, RN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Tuscaloosa, AL
National Provider Identifier
1245872589
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
1-141600 Issued in AL
Practice address
1060 Fairfax Park Ste C
Tuscaloosa, AL 35406-2837
Phone
(205) 752-7337
Fax
(205) 752-8013
NPI assigned
Oct 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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 1-141600 AL Primary

Addresses

Primary practice location

1060 Fairfax Park Ste C
Tuscaloosa, AL 35406-2837

Mailing address

1060 Fairfax Park Ste C
Tuscaloosa, AL 35406-2837
Phone (205) 752-7337

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-141600ALMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Bruce a Petitt M.D. P.C. PastSince Oct 13, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1245872589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 FAIRFAX PARK STE C",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062837",
            "telephone_number": "205-752-7337",
            "fax_number": "205-752-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 FAIRFAX PARK STE C",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062837",
            "telephone_number": "205-752-7337",
            "fax_number": "205-752-8013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNKIN",
        "first_name": "KRISTYN",
        "middle_name": "NICOLE",
        "credential": "RN, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "AL",
            "license": "1-141600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; 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.