Individual provider Active NPI

Kristina Marie Flanagan, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Coralville, IA
National Provider Identifier
1255782876
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
G129919 Issued in IA
Practice address
2180 Norcor Ave Ste B
Coralville, IA 52241-9748
Phone
(319) 359-1558
Fax
(319) 255-2423
NPI assigned
Jun 24, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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 G129919 IA Primary

Addresses

Primary practice location

2180 Norcor Ave Ste B
Coralville, IA 52241-9748

Mailing address

2090 Glen Oaks Dr
Coralville, IA 52241-3225
Phone (641) 660-9681

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20160811000317 IA Practitioner - Nurse Practitioner 0749574945 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G129919IAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Flanagan Obrien Mental Wellness PLLC CurrentSince Jun 1, 2023 Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

2180 Norcor Ave
Ste B
Coralville, IA 52241
Phone (319) 339-4633

2461 10th St
Ste 210
Coralville, IA 52241

2461 10th St
Ste 202
Coralville, IA 52241
Phone (319) 359-1558

Organizations & group practices 2

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": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1255782876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 GLEN OAKS DR",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522413225",
            "telephone_number": "641-660-9681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 NORCOR AVE STE B",
            "city": "CORALVILLE",
            "state": "IA",
            "postal_code": "522419748",
            "telephone_number": "319-359-1558",
            "fax_number": "319-255-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANAGAN",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G129919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coralville, IA

Sources for this page

Verify at the official NPI Registry.