Individual provider Active NPI

Kristine Kaye Burnstad, MSW,LCSW

  • Social Worker
  • Baraboo, WI
National Provider Identifier
1467410001
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6780123 Issued in WI
Practice address
1002 Lincoln Ave
Baraboo, WI 53913-1808
Phone
(608) 356-9884
Fax
(608) 356-0985
NPI assigned
May 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6780123 WI Primary

Addresses

Primary practice location

1002 Lincoln Ave
Baraboo, WI 53913-1808

Mailing address

1002 Lincoln Ave
Pauquette Center
Baraboo, WI 53913
Phone (608) 356-9055

Other identifiers 1

IdentifierTypeStateIssuer
43577200MedicaidWI

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

State licenses

LicenseStateTypeSpecialty
6780123WIMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Redi Clinic of Wauwatosa, SC PastSince Jan 1, 2001 Accepting new patients
Michael D Plooster MD SC Past Accepting new patients
Pathway to Wellness Community Clinic SC PastSince Jul 1, 2016 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467410001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 LINCOLN AVE",
            "address_2": "PAUQUETTE CENTER",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "53913",
            "telephone_number": "608-356-9055",
            "fax_number": "608-356-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 LINCOLN AVE",
            "city": "BARABOO",
            "state": "WI",
            "postal_code": "539131808",
            "telephone_number": "608-356-9884",
            "fax_number": "608-356-0985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNSTAD",
        "first_name": "KRISTINE",
        "middle_name": "KAYE",
        "name_prefix": "Ms.",
        "credential": "MSW,LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "6780123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43577200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baraboo, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.