Individual provider Active NPI

Kristin Elise Niemyer, NP

  • Acute Care Nurse Practitioner
  • Laurinburg, NC
National Provider Identifier
1457947640
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2000239473 Issued in NC
Practice address
500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone
(910) 291-7630
NPI assigned
Dec 12, 2020
Last updated
Aug 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2000239473 NC Primary

Addresses

Primary practice location

500 Lauchwood Dr
Laurinburg, NC 28352-5501

Mailing address

500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone (910) 291-7630

Other practice location 1

214 Cochran Ave
Fayetteville, NC 28301-3875
Phone (910) 482-4131

Other names 1

  • Miss Kristin Elise Culbreth Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20210125001173 NC Practitioner - Nurse Practitioner 2567876071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Georgetown University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scotland Memorial Hospital, IncGroup PAC ID 0648208504, 259 clinicians

Practice addresses (Care Compare)

500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone (910) 610-4172

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2000239473NCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Scotland Memorial Hospital Inc CurrentSince Dec 29, 2022 Accepting new patients
Scotland Memorial Hospital Inc CurrentSince Dec 29, 2022 Accepting new patients

Locations

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

Interoperability endpoints

  • Direct secure messaging: kniemyer523935@direct.medicine.duke.edu

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1607731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660089600000",
    "number": "1457947640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LAUCHWOOD DR",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525501",
            "telephone_number": "910-291-7630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LAUCHWOOD DR",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525501",
            "telephone_number": "910-291-7630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "214 Cochran Ave",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283013875",
            "country_code": "US",
            "telephone_number": "910-482-4131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIEMYER",
        "first_name": "KRISTIN",
        "middle_name": "ELISE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-12",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "2000239473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "CULBRETH",
            "middle_name": "ELISE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Laurinburg, NC

Sources for this page

Verify at the official NPI Registry.