Kristy Anne Pastush

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN209718 Issued in GA

Practice address

387 Goshen Church Way
Waleska, GA 30183-2347

Phone

(912) 230-9561

NPI assigned

Feb 19, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristy.pastush@3781.securemail.prognocis.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.

• Goshen Valley Foundation Inc

  • Community/Behavioral Health Agency
  • Canton, GA
  • NPI 1710238787
  NPD

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

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1699530675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 GOSHEN CHURCH WAY",
            "city": "WALESKA",
            "state": "GA",
            "postal_code": "301832347",
            "telephone_number": "912-230-9561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 GOSHEN CHURCH WAY",
            "city": "WALESKA",
            "state": "GA",
            "postal_code": "301832347",
            "telephone_number": "912-230-9561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASTUSH",
        "first_name": "KRISTY",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN209718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Marie Judkins
• Taz Hunter Kicklighter, MS, ATC
• Stephania Medina, ATC, LAT
• Marigrace Celeste Moncrief, LMSW
• Leah Sharp Ozment, LCSW
• Ashley Perdue, LAT, ATC
• Carissa Perine, RN
• Kiley Lynne Pinson
• Rivers Health and Wellness Pharmacy
• Roxanne Alexandria Rivers

• Family Nurse Practitioner in Waleska, GA
• Providers in Waleska, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.