Individual provider Active NPI

Kristina Marie Kinne, L.P.N.

  • Licensed Practical Nurse
  • Verona, NY
National Provider Identifier
1396941985
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
286262-1 Issued in NY
Practice address
5638 Greenfield Rd
Verona, NY 13478-3515
Phone
(131) 536-6024
NPI assigned
Jun 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 286262-1 NY Primary

Addresses

Primary practice location

5638 Greenfield Rd
Verona, NY 13478-3515

Mailing address

5638 Greenfield Rd
Verona, NY 13478-3515
Phone (131) 536-6024

Other identifiers 1

IdentifierTypeStateIssuer
02873343MedicaidNY

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
286262-1NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1396941985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5638 GREENFIELD RD",
            "city": "VERONA",
            "state": "NY",
            "postal_code": "134783515",
            "telephone_number": "131-536-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5638 GREENFIELD RD",
            "city": "VERONA",
            "state": "NY",
            "postal_code": "134783515",
            "telephone_number": "131-536-6024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNE",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "L.P.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "286262-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02873343",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Verona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.