Individual provider Active NPI

Kristine Marie Hammargren

  • Speech-Language Pathologist
  • Fairbanks, AK
National Provider Identifier
1407660590
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
234056 Issued in AK
Practice address
102 10TH Ave
Fairbanks, AK 99701-5003
Phone
(907) 759-7697
NPI assigned
Feb 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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 234056 AK Primary

Addresses

Primary practice location

102 10TH Ave
Fairbanks, AK 99701-5003

Mailing address

190 Humboldt Way
Fairbanks, AK 99709-2958
Phone (907) 347-7142

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250328003229 AK Practitioner - Qualified Speech Language Pathologist 3274063557 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nisma Therapy Services LLC Speech-Language Pathologist CurrentSince Feb 11, 2025 Accepting new patients

Locations

102 10th Ave
Fairbanks, AK 99701
Phone (907) 415-9331

Organizations & group practices 1

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": "1738800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1407660590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 HUMBOLDT WAY",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997092958",
            "telephone_number": "907-347-7142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 10TH AVE",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015003",
            "telephone_number": "907-759-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMARGREN",
        "first_name": "KRISTINE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AK",
            "license": "234056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.