Individual provider Active NPI

Kristin L West, RN

  • Registered Nurse
  • Davenport, IA
National Provider Identifier
1477859890
Registry record updated Feb 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
094735 Issued in IA
Practice address
1441 W. Centrral Park Ave
Vera French Community Mental Health Center
Davenport, IA 52804
Phone
(563) 383-1900
Fax
(563) 884-4638
NPI assigned
Feb 2, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 094735 IA Primary

Addresses

Primary practice location

1441 W. Centrral Park Ave
Vera French Community Mental Health Center
Davenport, IA 52804

Mailing address

1411 W. Central Park Ave
Vera French Community Mental Health Center
Davenport, IA 52804
Phone (563) 383-1900

Other identifiers 1

IdentifierTypeStateIssuer
42-0716337MedicaidIA

Other names 1

  • Kristin Haas Other name

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
094735IAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296604800000",
    "number": "1477859890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 W. CENTRAL PARK AVE",
            "address_2": "VERA FRENCH COMMUNITY MENTAL HEALTH CENTER",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "52804",
            "telephone_number": "563-383-1900",
            "fax_number": "563-884-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 W. CENTRRAL PARK AVE",
            "address_2": "VERA FRENCH COMMUNITY MENTAL HEALTH CENTER",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "52804",
            "telephone_number": "563-383-1900",
            "fax_number": "563-884-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "KRISTIN",
        "middle_name": "L",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-02",
        "last_updated": "2011-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "094735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42-0716337",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "HAAS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; 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.