Individual provider Active NPI

Dustin Christensen, DPM

  • Podiatrist
  • North Platte, NE
National Provider Identifier
1609215755
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
375 Issued in NE
Practice address
815 S Maple St
North Platte, NE 69101-5282
Phone
(308) 532-3600
Fax
(308) 532-6288
NPI assigned
Jun 21, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 12-00417 KS
Podiatrist 213E00000X 375 NE Primary

Addresses

Primary practice location

815 S Maple St
North Platte, NE 69101-5282

Mailing address

815 S Maple St
North Platte, NE 69101-5282
Phone (308) 532-3600

Other practice location 1

1010 Carondelet Dr
Ste 301
Kansas City, MO 64114-4859
Phone (816) 943-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, WY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160609002147 MO Practitioner - Podiatry 4183867203 Reassigns benefits to 1 organization
I20220414001673 WY Practitioner - Podiatry 4183867203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ivinson Memorial HospitalGroup PAC ID 8325304447, 61 clinicians

Practice addresses (Care Compare)

255 N 30TH St
Laramie, WY 82072-5140
Phone (307) 742-2142

Hospital & facility affiliations

  • Enhabit Home Health Home health agency, Laramie, WY, CCN 537077
  • Ivinson Memorial Hospital Hospital, Laramie, WY, CCN 530025

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue168
Removal of skin lesions1-10
Removal of nail tissue142
Removal or shaving of skin growth66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
165WYMDMarriage & Family Therapist
375NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ivinson Memorial Hospital CurrentSince Apr 18, 2022 Accepting new patients
Ivinson Memorial Hospital CurrentSince Apr 18, 2022 Accepting new patients

Locations

3116 Willett Dr
Laramie, WY 82072
Phone (307) 742-6319

255 N 30th St
Laramie, WY 82072
Phone (307) 742-2141

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.

Hospital & facility affiliations 2

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": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1609215755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 S MAPLE ST",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691015282",
            "telephone_number": "308-532-3600",
            "fax_number": "308-532-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 S MAPLE ST",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691015282",
            "telephone_number": "308-532-3600",
            "fax_number": "308-532-6288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Carondelet Dr",
            "address_2": "Ste 301",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641144859",
            "country_code": "US",
            "telephone_number": "816-943-1111",
            "fax_number": "816-943-1126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "DUSTIN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-21",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "KS",
            "license": "12-00417",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NE",
            "license": "375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Platte, NE

Sources for this page

Verify at the official NPI Registry.