Kristy F Speronis, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2612 Issued in SC

Practice address

1315 Roberts St
Camden, SC 29020-3737

Phone

(803) 713-6229

NPI assigned

Dec 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Cypress Health Systems Florida Inc.

  • Medicare Defined Swing Bed Hospital Unit
  • Williston, FL
  • NPI 1841481116
  NPD (past)

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1508920265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WYNFORD PL",
            "city": "BLYTHEWOOD",
            "state": "SC",
            "postal_code": "290167866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 ROBERTS ST",
            "city": "CAMDEN",
            "state": "SC",
            "postal_code": "290203737",
            "telephone_number": "803-713-6229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPERONIS",
        "first_name": "KRISTY",
        "middle_name": "F",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "2612",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "2612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "576005963",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Carolina CVS Pharmacy LLC
• South Carolina Heart Center PA
• Southeastern Foundation & Crawlspace Repair, LLC
• Southeastern Success Center, LLC
• Jill Cullipher Souza, CRNA
• Tiffany L. Sprinkle
• State of South Carolina
• Patricia G Steen, LPC
• Steeplechase Pathology LLC
• Brittany Nicole Stephens

• All providers in Camden, SC
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; 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.