Krysten Ann Green, MSN,APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209029061 Issued in IL

Practice address

800 N Main St
Anna, IL 62906-1665

Phone

(618) 833-4456

Fax

(618) 833-2371

NPI assigned

Dec 21, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

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.

• Centerstone of Illinois, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Frankfort, IL
  • NPI 1053455667
  Medicare reassignment NPD
• Centerstone of Illinois, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Alton, IL
  • NPI 1033570262
  NPD

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1508635244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W MAIN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962210",
            "telephone_number": "618-937-6483",
            "fax_number": "618-937-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 N MAIN ST",
            "city": "ANNA",
            "state": "IL",
            "postal_code": "629061665",
            "telephone_number": "618-833-4456",
            "fax_number": "618-833-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "KRYSTEN",
        "middle_name": "ANN",
        "credential": "MSN,APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-21",
        "last_updated": "2024-01-02",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209029061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Edward Gade, LCSW, CADC
• Keeley Glodo, LPN
• Timothy Goad, BGS
• Adam Brock Goforth
• Krystin Angel Grant, CNA
• H&S Pharmacies, LLC
• H&S Pharmacies, LLC
• Tyler Hale
• Brittany Deshay Hall, CNA
• Lakesha Hamby, AA, RN

• Psychiatric/Mental Health Nurse Practitioner in Anna, IL
• Providers in Anna, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.