Individual provider Active NPI

Kristan Horney, FNP-C

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1720590904
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024178393 Issued in VA
Practice address
1501 Imperial Ave
San Diego, CA 92101-7638
Phone
(619) 645-6045
NPI assigned
Oct 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024178393 VA Primary

Addresses

Primary practice location

1501 Imperial Ave
San Diego, CA 92101-7638

Mailing address

1501 Imperial Ave
San Diego, CA 92101-7638
Phone (619) 645-6045

Other names 1

  • Kristan Hinrichs Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230818002034 CA Order and Referring Only - Nurse Practitioner 8527420744

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024178393VAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1509148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1720590904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 IMPERIAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921017638",
            "telephone_number": "619-645-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 IMPERIAL AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921017638",
            "telephone_number": "619-645-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNEY",
        "first_name": "KRISTAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-28",
        "last_updated": "2022-01-11",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024178393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTAN",
            "last_name": "HINRICHS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.