Kristine Willoughby

Primary specialty

Transportation BrokerTaxonomy code 347E00000X

Practice address

505 S 25TH St
South Bend, IN 46615-2117

Phone

(574) 217-5997

NPI assigned

Mar 29, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: rides@kristinedrives.com

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

{
    "created_epoch": "1585440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585440000000",
    "number": "1326676024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S 25TH ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466152117",
            "telephone_number": "574-217-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S 25TH ST",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466152117",
            "telephone_number": "574-217-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "KRISTINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-29",
        "last_updated": "2020-03-29",
        "certification_date": "2020-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Rides@kristinedrives.com",
            "affiliation": "N",
            "endpointDescription": "Booking email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "505 S 25th St",
            "city": "South Bend",
            "state": "IN",
            "country_code": "US",
            "postal_code": "466152117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tayler Williams, RBT
• Tia Williams, RBT
• Tyra Williams
• Tyra Le Williams, RBT
• Ashley Anne Williamson, DO
• Lawrence Carlson Willoughby, LCSW
• Martyn A Wills, MD
• Aaliyah Wilson, RBT
• Alicia Marie Wilson, D.O.
• Christopher Neal Wilson, BS, OTR

• Transportation Broker in South Bend, IN
• Providers in South Bend, IN by specialty
• Transportation Broker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2020; 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.