Individual provider Active NPI

Kristin J McCracken, RN

  • Registered Nurse
  • Du Bois, PA
National Provider Identifier
1336370717
Registry record updated Aug 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN585913 Issued in PA
Practice address
5753 Shaffer Rd
Du Bois, PA 15801-3873
Phone
(814) 375-2703
Fax
(814) 375-1180
NPI assigned
Aug 3, 2009
Last updated
Aug 3, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN585913 PA Primary

Addresses

Primary practice location

5753 Shaffer Rd
Du Bois, PA 15801-3873

Mailing address

5753 Shaffer Rd
PO Box 525
Du Bois, PA 15801-3873
Phone (814) 375-2703

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
RN585913PAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Peritech Home Health Associates LLC Past Accepting new patients
Peritech Home Health Associates, LLC Past Accepting new patients

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, 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": "1249257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249257600000",
    "number": "1336370717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5753 SHAFFER RD",
            "address_2": "PO BOX 525",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158013873",
            "telephone_number": "814-375-2703",
            "fax_number": "814-375-1180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5753 SHAFFER RD",
            "city": "DU BOIS",
            "state": "PA",
            "postal_code": "158013873",
            "telephone_number": "814-375-2703",
            "fax_number": "814-375-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRACKEN",
        "first_name": "KRISTIN",
        "middle_name": "J",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-03",
        "last_updated": "2009-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN585913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Du Bois, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2009; 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.