NPIMap

Individual provider Active NPI

Kristin S Lake, M.D.

  • Rheumatology Physician
  • North Platte, NE
National Provider Identifier
1548209174
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
22906 Issued in NE
Practice address
500 W Leota St
Suite 100
North Platte, NE 69101-6576
Phone
(308) 534-4440
Fax
(308) 534-7675
NPI assigned
Jun 6, 2006
Last updated
Jan 9, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X 22906 NE Primary

Addresses

Primary practice location

500 W Leota St
Suite 100
North Platte, NE 69101-6576

Mailing address

500 W Leota St
Suite 100
North Platte, NE 69101-6576
Phone (308) 534-4440

Other names 1

  • Kristin S Bird Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040828000091 NE Practitioner - RheumatologyPractitioner - Internal Medicine 9739154238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
RheumatologyAlso: Internal Medicine
Education
University of Nebraska College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

516 W Leota St
Great Plains Health Rheumatology
North Platte, NE 69101-6533
Phone (308) 568-4800

601 W Leota St
North Platte, NE 69101-6525

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Platte Nebraska Hospital Corporation CurrentSince Jan 1, 2019 Accepting new patients
North Platte Nebraska Hospital Corporation Current Accepting new patients
Internal Medicine Associates of North Platte LLC PastSince Jan 1, 2002 Accepting new patients

Locations

500 W Leota St
Ste 100
North Platte, NE 69101
Phone (308) 520-0548

601 W Leota St
North Platte, NE 69101
Phone (308) 534-2288

Interoperability endpoints

  • Direct secure messaging: klake37084@direct.nebraskamed.com

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.

Hospital & facility affiliations 6

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": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1548209174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W LEOTA ST",
            "address_2": "SUITE 100",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016576",
            "telephone_number": "308-534-4440",
            "fax_number": "308-534-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W LEOTA ST",
            "address_2": "SUITE 100",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691016576",
            "telephone_number": "308-534-4440",
            "fax_number": "308-534-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "KRISTIN",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "NE",
            "license": "22906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "BIRD",
            "middle_name": "S",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in North Platte, NE

Sources for this page

Verify at the official NPI Registry.