Individual provider Active NPI

Kristy Mary Redmond, PMHNP-BC

  • Adult Psychiatric/Mental Health Registered Nurse
  • Plattsburgh, NY
National Provider Identifier
1558644377
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X
License
576713 Issued in NY
Practice address
63 Broad St
Plattsburgh, NY 12901-3315
Phone
(518) 563-8000
Fax
(518) 563-8261
NPI assigned
Sep 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Psychiatric/Mental Health Registered Nurse 163WP0809X 576713 NY Primary

Addresses

Primary practice location

63 Broad St
Plattsburgh, NY 12901-3315

Mailing address

20 Ampersand Dr
Plattsburgh, NY 12901-6500
Phone (518) 561-8480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20181029000909 NY Practitioner - Nurse Practitioner 5294088845 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
576713NYMDAdult Psychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Behavioral Health Services North, Inc. CurrentSince Sep 28, 2018 Accepting new patients
Behavioral Health Services North, Inc. CurrentSince Sep 28, 2018 Accepting new patients
Champlain Valley Family Center PastSince Oct 13, 2024 Accepting new patients

Locations

2155 State Route 22B
Morrisonville, NY 12962
Phone (518) 562-3847

63 Broad St
Plattsburgh, NY 12901
Phone (518) 563-1160

22 US Oval
Ste 218
Plattsburgh, NY 12903
Phone (518) 534-9666

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1317168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1558644377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 AMPERSAND DR",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129016500",
            "telephone_number": "518-561-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 BROAD ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129013315",
            "telephone_number": "518-563-8000",
            "fax_number": "518-563-8261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDMOND",
        "first_name": "KRISTY",
        "middle_name": "MARY",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-28",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "NY",
            "license": "576713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plattsburgh, NY

Sources for this page

Verify at the official NPI Registry.