Individual provider Active NPI

Karen L Kristy, APRN, BC

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Beachwood, OH
National Provider Identifier
1609097393
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
RN172097COA-1 Issued in OH
Practice address
23240 Chagrin Blvd.
Suite 270
Beachwood, OH 44122
Phone
(216) 765-0500
Fax
(216) 765-0521
NPI assigned
May 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

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 Clinical Nurse Specialist 364SP0809X RN172097COA-1 OH Primary

Addresses

Primary practice location

23240 Chagrin Blvd.
Suite 270
Beachwood, OH 44122

Mailing address

3085 Fairmount Blvd
Rear
Cleveland Heights, OH 44118-4128
Phone (216) 548-5004

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
07603OHMDPhysical Therapy Assistant
RN172097COA-1OHMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482105600000",
    "number": "1609097393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3085 FAIRMOUNT BLVD",
            "address_2": "REAR",
            "city": "CLEVELAND HEIGHTS",
            "state": "OH",
            "postal_code": "441184128",
            "telephone_number": "216-548-5004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23240 CHAGRIN BLVD.",
            "address_2": "SUITE 270",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "44122",
            "telephone_number": "216-765-0500",
            "fax_number": "216-765-0521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTY",
        "first_name": "KAREN",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2016-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "OH",
            "license": "RN172097COA-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; 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.