Individual provider Active NPI

Kristine Shirvinski

  • Registered Dietitian
  • Bloomsburg, PA
National Provider Identifier
1619680741
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN003547 Issued in PA
Practice address
240 Mall Blvd
Bloomsburg, PA 17815-8306
Phone
(570) 784-8303
NPI assigned
Jan 4, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DN003547 PA Primary

Addresses

Primary practice location

240 Mall Blvd
Bloomsburg, PA 17815-8306

Mailing address

155 S 3Rd St
Hughesville, PA 17737-1712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230131000086 PA Practitioner - Registered Dietitian Or Nutrition Professional 1456722420 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Registered Dietitian Or Nutrition Professional
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

240 Mall Blvd
Bloomsburg, PA 17815-8389
Phone (570) 416-5435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN003547PAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Feb 20, 2023 Accepting new patients
Geisinger Clinic CurrentSince Feb 20, 2023 Accepting new patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

240 Mall Blvd
Bloomsburg, PA 17815
Phone (570) 416-5435

100 N Academy Ave
Danville, PA 17822

255 Route 220 Hwy
Ste 209
Muncy, PA 17756

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1619680741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 S 3RD ST",
            "city": "HUGHESVILLE",
            "state": "PA",
            "postal_code": "177371712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MALL BLVD",
            "city": "BLOOMSBURG",
            "state": "PA",
            "postal_code": "178158306",
            "telephone_number": "570-784-8303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIRVINSKI",
        "first_name": "KRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN003547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.