Individual provider Active NPI

Kristin Noel Lindblom

  • Behavior Technician
  • Grand Rapids, MI
National Provider Identifier
1639713613
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
2460 Burton St SE Ste 101
Grand Rapids, MI 49546-4800
Phone
(616) 278-1201
NPI assigned
Nov 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

2460 Burton St SE Ste 101
Grand Rapids, MI 49546-4800

Mailing address

1210 Dale CT NE
Grand Rapids, MI 49505-5445
Phone (616) 291-6172

Other practice location 1

1210 Dale Ct NE
Grand Rapids, MI 49505-5445
Phone (616) 291-6172

Other practice location 2

1210 Dale Ct NE
Grand Rapids, MI 49505-5445
Phone (616) 291-6172

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

NPI Registry JSON

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1639713613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 DALE CT NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495055445",
            "telephone_number": "616-291-6172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 BURTON ST SE STE 101",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495464800",
            "telephone_number": "616-278-1201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1210 Dale Ct NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495055445",
            "country_code": "US",
            "telephone_number": "616-291-6172",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1210 Dale Ct NE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495055445",
            "country_code": "US",
            "telephone_number": "616-291-6172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINDBLOM",
        "first_name": "KRISTIN",
        "middle_name": "NOEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; 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.