Krishna B Bista

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

3107 Blue Spruce CT SE
Kentwood, MI 49512-2872

Phone

(616) 219-5543

Fax

(616) 469-1246

NPI assigned

Jan 10, 2024

Reactivated

Sep 21, 2026

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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

{
    "created_epoch": "1704844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1275304099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3167 BLAIRVIEW PKWY SE APT 201",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495121798",
            "telephone_number": "616-219-5543",
            "fax_number": "616-469-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3107 BLUE SPRUCE CT SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495122872",
            "telephone_number": "616-219-5543",
            "fax_number": "616-469-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISTA",
        "first_name": "KRISHNA",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-10",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "deactivation_date": "2024-04-02",
        "reactivation_date": "2026-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Hannah Bignall
• Rachael Marie Billingsley, D.P.T
• Biocorrect, LLC
• Julia L Birdsall
• Rebecca K Bisson, B.A.
• Erin Louise Blackburn
• Hannah Blackwell, SLP
• Sandra Lee Blackwell
• Blue Waters Counseling
• Tara C Blue

• Community Health Worker in Kentwood, MI
• Providers in Kentwood, MI by specialty
• Community Health Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.