Kristin Van Konynenburg, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

42439 Issued in CO

Practice address

600 S Airport Rd Unit A203
Longmont, CO 80503-6427

Phone

(303) 776-0467

Fax

(303) 776-0387

NPI assigned

Nov 18, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2012 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kristin.vankonynenburg.p36@direct.ipn.nextgenshare.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.

• Whole Family Health Care of Longmont

  • Health Service Clinic/Center
  • Longmont, CO
  • NPI 1932501202
  NPD (past) Authorized official
• Contra Costa County

  • General Acute Care Hospital
  • Martinez, CA
  • NPI 1386719086
  NPD (past)

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618444800000",
    "number": "1801878434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1067 S HOVER ST",
            "address_2": "UNIT E",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805017904",
            "telephone_number": "720-253-5648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S AIRPORT RD UNIT A203",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805036427",
            "telephone_number": "303-776-0467",
            "fax_number": "303-776-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN KONYNENBURG",
        "first_name": "KRISTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2021-04-15",
        "certification_date": "2021-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "42439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31238505",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alicia Valenzo, PT, DPT
• Anna Valiante, LCSW
• Valor Counseling and Holistic Services
• Barbara Valusek, LPC
• Ingrid Van Haitsma, LCSW
• John Vandegrift, MA, CAC I
• Maggie Vandenberg, DVM
• Rebecca Vanderveen
• Rachel Baer Vanharken, LCSW
• Charles James Vanhook, M.D.

• All providers in Longmont, CO
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.