Individual provider Active NPI

Kristine Marie Thormodson, LPN

  • Licensed Practical Nurse
  • Eau Claire, WI
National Provider Identifier
1376829960
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
310367-31 Issued in WI
Practice address
2000 N Oxford Ave
Building Two
Eau Claire, WI 54703-5184
Phone
(715) 834-1074
Fax
(715) 834-1078
NPI assigned
Oct 26, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 310367-31 WI Primary

Addresses

Primary practice location

2000 N Oxford Ave
Building Two
Eau Claire, WI 54703-5184

Mailing address

2000 N Oxford Ave
Building Two
Eau Claire, WI 54703-5184
Phone (715) 834-1074

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

State licenses

LicenseStateTypeSpecialty
310367-31WIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1376829960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 N OXFORD AVE",
            "address_2": "BUILDING TWO",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547035184",
            "telephone_number": "715-834-1074",
            "fax_number": "715-834-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 N OXFORD AVE",
            "address_2": "BUILDING TWO",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547035184",
            "telephone_number": "715-834-1074",
            "fax_number": "715-834-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORMODSON",
        "first_name": "KRISTINE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-26",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "310367-31",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.