Individual provider Active NPI

Kirsten Lorraine Scott, AGCNS-BC

  • Emergency Clinical Nurse Specialist
  • Traverse City, MI
National Provider Identifier
1669148565
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Clinical Nurse SpecialistTaxonomy code 364SE0003X
License
4704318996 Issued in MI
Practice address
1105 6TH St
Traverse City, MI 49684-2386
Phone
(231) 392-0143
NPI assigned
Aug 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Clinical Nurse Specialist 364SE0003X 4704318996 MI Primary

Addresses

Primary practice location

1105 6TH St
Traverse City, MI 49684-2386

Mailing address

4432 Townline Rd NW
Williamsburg, MI 49690-9651
Phone (269) 348-5880

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kscott23@mhc.net Direct

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
4704318996MIMDEmergency Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1669148565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4432 TOWNLINE RD NW",
            "city": "WILLIAMSBURG",
            "state": "MI",
            "postal_code": "496909651",
            "telephone_number": "269-348-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 6TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842386",
            "telephone_number": "231-392-0143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "KIRSTEN",
        "middle_name": "LORRAINE",
        "credential": "AGCNS-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-19",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SE0003X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Emergency",
            "state": "MI",
            "license": "4704318996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kscott23@mhc.net",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1105 6th St",
            "city": "Traverse City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "496842386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.