Kristin Nicole Stark, MSN, CNM, WHNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

218557 Issued in AZ

Practice address

6678 W Thunderbird Rd
Glendale, AZ 85306-3721

Phone

(602) 978-1500

Fax

(602) 978-8944

NPI assigned

Oct 19, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Miss Kristin Nicole Chambers Former name

Medicare fee-for-service enrollment

Enrolled in AZ2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Genesis OB GYN PLLCGroup PAC ID 4284724279, 109 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Master of Science - Nursing, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19050/brand/1/csg/1/fhir/r4
• Direct secure messaging: kristin.starkwhnp.p1@direct.dwobgyn.nextgenshare.com
• Direct secure messaging: kristin.stark.1@14294.direct.athenahealth.com
• Direct secure messaging: kristin.stark.1@19050.direct.athenahealth.com

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.

• Genesis OB GYN PLLC

  • Obstetrics & Gynecology Physician
  • Tucson, AZ
  • NPI 1992994214

  Maternal & Fetal Medicine

  Medicare reassignment Care Compare group NPD
• Arizona OB GYN Affiliates PC

  • Specialist
  • Phoenix, AZ
  • NPI 1750589404
  Medicare reassignment NPD
• Desert West Obstetrics & Gynecology LTD

  • Obstetrics & Gynecology Physician
  • Glendale, AZ
  • NPI 1588654560
  Medicare reassignment NPD

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1689140386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 N CENTRAL AVE STE 1600",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122908",
            "telephone_number": "602-323-3344",
            "fax_number": "602-323-3496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6678 W THUNDERBIRD RD",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063721",
            "telephone_number": "602-978-1500",
            "fax_number": "602-978-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "KRISTIN",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "MSN, CNM, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AZ",
            "license": "218557",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "218557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098184",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "CHAMBERS",
            "middle_name": "NICOLE",
            "prefix": "MISS",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathleen Stansberry
• Adriana Wanda Stapella, MS, OTRL/L
• Janet Staples, PT, DPT
• Starcare Homes LLC
• Stargate Behavioral Health Services LLC
• Starlight Care Seniors,LLC
• State 48 Dental PLLC
• Domineek Staten
• Stateserv Medical of Phoenix LLC
• Candice Michelle Steel, B.S. SLP

• Women's Health Nurse Practitioner in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Women's Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.