Individual provider Active NPI

Kristin Fields, RN, MSN, MA, CCC-SLP

  • Speech-Language Pathologist
  • Boulder, CO
National Provider Identifier
1376943415
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0000566 Issued in CO
Practice address
8011 Fox Ridge Court
Boulder, CO 80301
Phone
(720) 938-0108
Fax
(970) 221-1073
NPI assigned
Aug 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 0000566 CO Primary

Addresses

Primary practice location

8011 Fox Ridge Court
Boulder, CO 80301

Mailing address

8011 Fox Ridge CT
Boulder, CO 80301-5005
Phone (720) 938-0108

Other names 1

  • Kristin Johnson Former name

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)
Enrolled
Credentials
Master of Arts, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
0000566COMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1376943415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8011 FOX RIDGE CT",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803015005",
            "telephone_number": "720-938-0108",
            "fax_number": "970-221-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8011 FOX RIDGE COURT",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80301",
            "telephone_number": "720-938-0108",
            "fax_number": "970-221-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDS",
        "first_name": "KRISTIN",
        "credential": "RN, MSN, MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-26",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "0000566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "JOHNSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; 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.