Individual provider Active NPI

Kristin Marie Guldenschuh, NP-C

  • Family Nurse Practitioner
  • Virginia Beach, VA
National Provider Identifier
1457607293
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024169930 Issued in VA
Practice address
1950 Glenn Mitchell Dr Ste 310
Virginia Beach, VA 23456-0019
Phone
(757) 507-0255
Fax
(757) 507-0256
NPI assigned
Jul 31, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024169930 VA Primary

Addresses

Primary practice location

1950 Glenn Mitchell Dr Ste 310
Virginia Beach, VA 23456-0019

Mailing address

1950 Glenn Mitchell Dr Ste 310
Virginia Beach, VA 23456-0019
Phone (757) 507-0255

Other practice location 1

601 Childrens Ln
Norfolk, VA 23507-1910
Phone (757) 668-7858

Other names 1

  • Kristin M Clark Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20121019000023 VA Practitioner - Nurse Practitioner 4981854445 Reassigns benefits to 1 organization

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: kguldenschuh175662@direct.sentara.net

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": "1343692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1457607293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 GLENN MITCHELL DR STE 310",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560019",
            "telephone_number": "757-507-0255",
            "fax_number": "757-507-0256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 GLENN MITCHELL DR STE 310",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234560019",
            "telephone_number": "757-507-0255",
            "fax_number": "757-507-0256"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Childrens Ln",
            "address_purpose": "LOCATION",
            "city": "Norfolk",
            "state": "VA",
            "postal_code": "235071910",
            "country_code": "US",
            "telephone_number": "757-668-7858",
            "fax_number": "757-668-9915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GULDENSCHUH",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-31",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024169930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "CLARK",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.