Individual provider Active NPI

Kristen M Patterson, NP-C

  • Adult Health Nurse Practitioner
  • Westlake, OH
National Provider Identifier
1790177244
Registry record updated Apr 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN.CNP.16300 Issued in OH
Practice address
850 Columbia Rd
Suite 200
Westlake, OH 44145-1493
Phone
(440) 808-1212
Fax
(440) 808-0321
NPI assigned
Feb 20, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X COA16300 OH
Adult Health Nurse Practitioner 363LA2200X APRN.CNP.16300 OH Primary

Addresses

Primary practice location

850 Columbia Rd
Suite 200
Westlake, OH 44145-1493

Mailing address

850 Columbia Rd Ste 200
Westlake, OH 44145-7215
Phone (440) 808-1212

Other identifiers 1

IdentifierTypeStateIssuer
0120067MedicaidOH

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)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
COA16300OHMDNurse Practitioner
APRN.CNP.16300OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Shore Endoscopy Center Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1424390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1790177244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 COLUMBIA RD STE 200",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441457215",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 COLUMBIA RD",
            "address_2": "SUITE 200",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441451493",
            "telephone_number": "440-808-1212",
            "fax_number": "440-808-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-20",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA16300",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "APRN.CNP.16300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0120067",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; 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.