Individual provider Active NPI

Kristin A. Anderson-Cronin, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Green Bay, WI
National Provider Identifier
1558650705
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5424-33 Issued in WI
Practice address
3150 Gershwin Dr
Green Bay, WI 54311-4328
Phone
(920) 391-6940
NPI assigned
Mar 28, 2011
Last updated
Apr 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 170979-030 WI
Psychiatric/Mental Health Registered Nurse 163WP0808X 5424-33 WI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5424-33 WI Primary

Addresses

Primary practice location

3150 Gershwin Dr
Green Bay, WI 54311-4328

Mailing address

3150 Gershwin Dr
Green Bay, WI 54311-4328
Phone (920) 391-6940

Other identifiers 2

IdentifierTypeStateIssuer
1558650705MedicaidWI
000001545OtherWIMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20131111000926 WI Practitioner - Nurse Practitioner 7911133426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
May accept Medicare assignment
Group practices
County of BrownGroup PAC ID 1355435900, 16 clinicians

Practice addresses (Care Compare)

3150 Gershwin Dr
Green Bay, WI 54311-4328
Phone (920) 391-4700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
170979-030WIMDRegistered Nurse
5424-33WIMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
County of Brown CurrentSince Aug 28, 2023 Accepting new patients
County of Brown CurrentSince Aug 28, 2023 Accepting new patients

Locations

3150 Gershwin Dr
Green Bay, WI 54311
Phone (920) 391-4700

Organizations & group practices 2

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 5

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": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1558650705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 GERSHWIN DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114328",
            "telephone_number": "920-391-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 GERSHWIN DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543114328",
            "telephone_number": "920-391-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON-CRONIN",
        "first_name": "KRISTIN",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-28",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "170979-030",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "WI",
            "license": "5424-33",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WI",
            "license": "5424-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558650705",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "000001545",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

Verify at the official NPI Registry.