Individual provider Active NPI

Kristy Macbride

  • Registered Nurse
  • Mount Pleasant, SC
National Provider Identifier
1619394871
Registry record updated Mar 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
84195 Issued in SC
Practice address
1539 Heron Ave
Mt Pleasant, SC 29464-3939
Phone
(843) 532-9608
NPI assigned
Mar 26, 2014
Last updated
Mar 26, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 84195 SC Primary

Addresses

Primary practice location

1539 Heron Ave
Mt Pleasant, SC 29464-3939

Mailing address

1539 Heron Ave
Mt Pleasant, SC 29464-3939
Phone (843) 532-9608

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
84195SCMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1395792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395792000000",
    "number": "1619394871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1539 HERON AVE",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643939",
            "telephone_number": "843-532-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1539 HERON AVE",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "294643939",
            "telephone_number": "843-532-9608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACBRIDE",
        "first_name": "KRISTY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-26",
        "last_updated": "2014-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "84195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; 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.