Individual provider Active NPI

Kristian R Oenbrink, APRN

  • Internal Medicine Physician
  • Lynn Haven, FL
National Provider Identifier
1790364081
Registry record updated Apr 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
APRN11012280 Issued in FL
Practice address
1000 Ohio Ave
Lynn Haven, FL 32444-2356
Phone
(850) 371-9932
Fax
(850) 271-4113
NPI assigned
Apr 5, 2021
Last updated
Apr 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X APRN11012280 FL Primary

Addresses

Primary practice location

1000 Ohio Ave
Lynn Haven, FL 32444-2356

Mailing address

PO Box 1147
Lynn Haven, FL 32444-1147
Phone (850) 371-9932

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210629001903 FL Practitioner - Nurse Practitioner 7517368459 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Panama Internal Medicine AssociatesGroup PAC ID 8729013412, 3 clinicians

Practice addresses (Care Compare)

1000 Ohio Ave
Lynn Haven, FL 32444-2356
Phone (850) 371-9932

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Panama Internal Medicine Associates CurrentSince Apr 11, 2021 Accepting new patients
Panama Internal Medicine Associates Internal Medicine CurrentSince Apr 1, 2021 Accepting new patients

Locations

1000 Ohio Ave
Lynn Haven, FL 32444
Phone (850) 271-3006

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23530/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kristian.oenbrink.1@23530.direct.athenahealth.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1790364081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1147",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324441147",
            "telephone_number": "850-371-9932",
            "fax_number": "850-271-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 OHIO AVE",
            "city": "LYNN HAVEN",
            "state": "FL",
            "postal_code": "324442356",
            "telephone_number": "850-371-9932",
            "fax_number": "850-271-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OENBRINK",
        "first_name": "KRISTIAN",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "APRN11012280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynn Haven, FL

Sources for this page

Verify at the official NPI Registry.