Individual provider Active NPI

Kristen Sandefur, APRN

  • Nurse Practitioner
  • Akron, OH
National Provider Identifier
1659930568
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN.CNP.024384 Issued in OH
Practice address
2215 E Waterloo Rd Ste 313
Akron, OH 44312-3856
Phone
(330) 208-2720
NPI assigned
Jun 13, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN.CNP.024384 OH Primary

Addresses

Primary practice location

2215 E Waterloo Rd Ste 313
Akron, OH 44312-3856

Mailing address

2215 E Waterloo Rd Ste 313
Akron, OH 44312-3856
Phone (330) 208-2720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20190805003466 OH Practitioner - Nurse Practitioner 9830426451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians

Practice addresses (Care Compare)

525 E Market St
Akron, OH 44304-1619

95 Arch St
Suite 215
Akron, OH 44304-1467
Phone (330) 434-4145

Hospital & facility affiliations

  • Summa Health System Hospital, Akron, OH, CCN 360020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.024384OHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summa Physicians LLC CurrentSince Feb 17, 2020 Accepting new patients
Summa Physicians LLC Nurse Practitioner CurrentSince Feb 17, 2020 Accepting new patients
Summa Physicians LLC Current Accepting new patients
Summa Physicians LLC Past Accepting new patients

Locations

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

75 Arch St
Ste 201
Akron, OH 44304
Phone (330) 375-7055

1077 Gorge Blvd
Akron, OH 44310
Phone (234) 312-5691

Interoperability endpoints

  • Direct secure messaging: ksandefur29458@summahealth-direct.org

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.

Hospital & facility affiliations 3

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": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1659930568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 E WATERLOO RD STE 313",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443123856",
            "telephone_number": "330-208-2720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 E WATERLOO RD STE 313",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443123856",
            "telephone_number": "330-208-2720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDEFUR",
        "first_name": "KRISTEN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "APRN.CNP.024384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.