Individual provider Active NPI

Kristin J McQuistan, APRN

  • Nurse Practitioner
  • Lincoln, NE
National Provider Identifier
1356877385
Registry record updated Jun 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
112258 Issued in NE
Practice address
4545 R St
Ste 100
Lincoln, NE 68503-3799
Phone
(402) 465-4545
Fax
(402) 465-3621
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 112258 NE Primary

Addresses

Primary practice location

4545 R St
Ste 100
Lincoln, NE 68503-3799

Mailing address

4545 R St
Ste 100
Lincoln, NE 68503-3799
Phone (402) 465-4545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210702000907 IA Practitioner - Nurse Practitioner 9335419597
I20231113001684 ID Practitioner - Nurse Practitioner 9335419597 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
112258NEMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Health Network LLC Nurse Practitioner CurrentSince Jul 1, 2021 Accepting new patients
Lincoln Digestive Health Center LLC PastSince Jul 1, 2017 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

4620 E 53rd St
Ste 200
Davenport, IA 52807
Phone (563) 213-5100

3597 E Monarch Sky Ln
Ste 240
Meridian, ID 83646
Phone (208) 996-3519

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498694400000",
    "number": "1356877385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 R ST",
            "address_2": "STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685033799",
            "telephone_number": "402-465-4545",
            "fax_number": "402-465-3621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 R ST",
            "address_2": "STE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685033799",
            "telephone_number": "402-465-4545",
            "fax_number": "402-465-3621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCQUISTAN",
        "first_name": "KRISTIN",
        "middle_name": "J",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NE",
            "license": "112258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, NE

Sources for this page

Verify at the official NPI Registry.