Individual provider Active NPI

Krista Costantino

  • Licensed Practical Nurse
  • North Tonawanda, NY
National Provider Identifier
1558664490
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
272055-1 Issued in NY
Practice address
7247 Ward Rd
North Tonawanda, NY 14120-1437
Phone
(716) 245-8306
NPI assigned
Dec 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X 272055-01 NY
Pediatric Clinical Nurse Specialist 364SP0200X 272055-01 NY
Licensed Practical Nurse 164W00000X 272055-1 NY Primary

Addresses

Primary practice location

7247 Ward Rd
North Tonawanda, NY 14120-1437

Mailing address

7247 Ward Rd
North Tonawanda, NY 14120-1437
Phone (716) 245-8306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
272055-1NYMDLicensed Practical Nurse
272055-01NYMDAdult Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1558664490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7247 WARD RD",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141201437",
            "telephone_number": "716-245-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7247 WARD RD",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141201437",
            "telephone_number": "716-245-8306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTANTINO",
        "first_name": "KRISTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-15",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "NY",
            "license": "272055-01",
            "primary": false
        },
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "NY",
            "license": "272055-01",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "272055-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.