Individual provider Active NPI

Khristeen Angela Sproul, FNP

  • Family Nurse Practitioner
  • Canandaigua, NY
National Provider Identifier
1609767623
Registry record updated Jul 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
357286 Issued in NY
Practice address
350 Parrish St
Canandaigua, NY 14424-1731
Phone
(585) 396-6000
NPI assigned
Jul 9, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 357286 NY Primary

Addresses

Primary practice location

350 Parrish St
Canandaigua, NY 14424-1731

Mailing address

350 Parrish St
Canandaigua, NY 14424-1731

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20260526000424 NY Practitioner - Nurse Practitioner 7315847183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1160 Corporate Dr
Farmington, NY 14425-9534
Phone (585) 924-1510

15 Canandaigua St
Shortsville, NY 14548-9763
Phone (585) 289-3560

699 S Main St
Suite 5
Canandaigua, NY 14424-2208
Phone (585) 396-6050

800 W Miller St
Suite 11
Newark, NY 14513-1354
Phone (315) 226-8900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
357286NYMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: ksproul134537@direct.urmc.rochester.edu

Organizations & group practices 1

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 1

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": "1752019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1609767623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 PARRISH ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 PARRISH ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241731",
            "telephone_number": "585-396-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPROUL",
        "first_name": "KHRISTEEN",
        "middle_name": "ANGELA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-09",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "357286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canandaigua, NY

Sources for this page

Verify at the official NPI Registry.