Kristin Marie Elliott, ACNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704207133 Issued in MI

Practice address

2615 Electric Avenue
Port Huron, MI 48060

Phone

(810) 990-8222

Fax

(810) 937-5592

NPI assigned

Aug 30, 2009

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

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/a2aabeb9-840e-4290-b28b-f0bb3ed955f9/

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.

• Harbor Beach Community Hospital Inc

  • Critical Access Hospital
  • Harbor Beach, MI
  • NPI 1124089743
  Medicare reassignment NPD
• Harbor Beach Community Hospital Inc

  • Family Medicine Physician
  • Harbor Beach, MI
  • NPI 1619059458
  Medicare reassignment NPD
• Port Huron Physicians Medical Group PC

  • Family Medicine Physician
  • Fort Gratiot, MI
  • NPI 1598141640
  Medicare reassignment NPD
• St Clair Pulmonary & Critical Care P C

  • Pulmonary Disease Physician
  • Port Huron, MI
  • NPI 1710909478
  Medicare reassignment NPD
• Harbor Beach Community Hospital Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Harbor Beach, MI
  • NPI 1730146630
  NPD

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

{
    "created_epoch": "1251590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691020800000",
    "number": "1801029418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 ELECTRIC AVENUE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "48060",
            "telephone_number": "810-990-8222",
            "fax_number": "810-937-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 ELECTRIC AVENUE",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "48060",
            "telephone_number": "810-990-8222",
            "fax_number": "810-937-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-30",
        "last_updated": "2023-08-03",
        "certification_date": "2023-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704207133",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704207133",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adnan Ejupovic, DPM
• Jennifer Elam, O.D.
• Aldia D Elash, C.R.N.A.
• Sultan Elhaj, MD
• Constance Rae Elliott-Fowler
• Yehia Ibraham Elsafy, MD
• Emergency Care Specialists of St. Clair County, P. C.
• Emergency Care Specialists of St. Clair County, P.C.
• Kari Empson
• Kaitlyn Marie Enders, B.S.

• Nurse Practitioner in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.