Kristen Van Staalduinen

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

019760 Issued in OH

Practice address

4353 E State Route 73
Suite 120
Waynesville, OH 45068-8812

Phone

(937) 897-0085

NPI assigned

Sep 6, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Nurse Practitioner

Education

University of Cincinnati College of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Medical GroupGroup PAC ID 2860386349, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fidelity Health Care Home health agency, Moraine, OH, CCN 367160
• Miami Valley Hospital Hospital, Dayton, OH, CCN 360051
• Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
• Atrium Medical Center Hospital, Franklin, OH, CCN 360076
• Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
• Kettering Health Miamisburg Hospital, Miamisburg, OH, CCN 360239

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristen.van.staalduinen.1@237.direct.athenahealth.com

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.

• Providence Medical Group

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1972533149
  Medicare reassignment Care Compare group NPD
• Providence Medical Group, Inc.

  dba PMG Vascular Imaging

  • Diagnostic Radiology Physician
  • Moraine, OH
  • NPI 1659726768
  NPD
• Providence Medical Group

  • Podiatrist
  • Moraine, OH
  • NPI 1811304595
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Atrium Medical Center

  • General Acute Care Hospital
  • Franklin, OH
  • NPI 1700950060
  Care Compare affiliation
• Dayton Osteopathic Hospital

  dba Kettering Health Dayton

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1053339507
  Care Compare affiliation
• Fidelity Health Care Inc

  dba Fidelity Nursing Systems

  • Home Health Agency
  • Moraine, OH
  • NPI 1235127838
  Care Compare affiliation
• Kettering Medical Center

  dba Kettering Health Main Campus

  • General Acute Care Hospital
  • Kettering, OH
  • NPI 1043233984
  Care Compare affiliation
• Kettering Medical Center

  dba Kettering Health Miamisburg

  • General Acute Care Hospital
  • Miamisburg, OH
  • NPI 1316966518
  Care Compare affiliation
• Miami Valley Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1073688354
  Care Compare affiliation

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1578010740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4353 E STATE ROUTE 73 STE 120",
            "city": "WAYNESVILLE",
            "state": "OH",
            "postal_code": "450688814",
            "telephone_number": "513-897-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4353 E STATE ROUTE 73",
            "address_2": "SUITE 120",
            "city": "WAYNESVILLE",
            "state": "OH",
            "postal_code": "450688812",
            "telephone_number": "937-897-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN STAALDUINEN",
        "first_name": "KRISTEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-06",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "019760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanessa Anne Stone
• David J Studzinski, DVM
• Christy Ann Susec, DVM
• James Taylor
• Tranquility Home Health Solutions LLC
• Denise Wade
• Kathy Ward
• Wayne Local Schools
• Wayne Township Trustees (Wayne Township Fire Department)
• Waynesville Family Vision

• Family Nurse Practitioner in Waynesville, OH
• Providers in Waynesville, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.