Individual provider Active NPI

Kristina Goubeaud, RN

  • School Registered Nurse
  • New Rochelle, NY
National Provider Identifier
1629445218
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
School Registered NurseTaxonomy code 163WS0200X
License
657876 Issued in NY
Practice address
515 North Ave
New Rochelle, NY 10801-3405
Phone
(914) 576-4264
Fax
(914) 632-3371
NPI assigned
Aug 31, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 657876 NY Primary

Addresses

Primary practice location

515 North Ave
New Rochelle, NY 10801-3405

Mailing address

515 North Ave
New Rochelle, NY 10801-3405
Phone (914) 576-4264

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
657876NYMDSchool Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1629445218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 NORTH AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108013405",
            "telephone_number": "914-576-4264",
            "fax_number": "914-632-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 NORTH AVE",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108013405",
            "telephone_number": "914-576-4264",
            "fax_number": "914-632-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUBEAUD",
        "first_name": "KRISTINA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "657876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; 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.