Individual provider Active NPI

Kristian Coon, CRNP

  • Acute Care Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1477946325
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-136705 Issued in AL
Practice address
619 19TH St S
JT 807
Birmingham, AL 35249-6810
Phone
(205) 996-9570
Fax
(205) 934-9118
NPI assigned
Mar 16, 2015
Last updated
Jun 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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 1-136705 AL Primary

Addresses

Primary practice location

619 19TH St S
JT 807
Birmingham, AL 35249-6810

Mailing address

619 19TH Street Sout
JT 807
Birmingham, AL 35249-6810
Phone (205) 996-9570

Other practice location 1

1424 Montclair Rd
Irondale, AL 35210-2208
Phone (334) 201-3106

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kebaker@direct.uabmedicine.org Direct University of Alabama Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20150506000074 AL Practitioner - Nurse Practitioner 1557680089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Alabama Health Services Foundation, PC. CurrentSince Apr 8, 2015 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

619 19th St S
#807
Birmingham, AL 35249
Phone (205) 996-9570

Interoperability endpoints

  • Direct secure messaging: kebaker@direct.uabmedicine.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1477946325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "619 19TH STREET SOUT",
            "address_2": "JT 807",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352496810",
            "telephone_number": "205-996-9570",
            "fax_number": "205-934-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 19TH ST S",
            "address_2": "JT 807",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352496810",
            "telephone_number": "205-996-9570",
            "fax_number": "205-934-9118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1424 Montclair Rd",
            "address_purpose": "LOCATION",
            "city": "Irondale",
            "state": "AL",
            "postal_code": "352102208",
            "country_code": "US",
            "telephone_number": "334-201-3106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COON",
        "first_name": "KRISTIAN",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-16",
        "last_updated": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-136705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kebaker@direct.uabmedicine.org",
            "affiliation": "Y",
            "affiliationName": "University of Alabama Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1424 Montclair Rd",
            "city": "Irondale",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352102208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.