Active NPI
Kristyn Michelle Costin
- Occupational Therapist
- Clarksville, IN
National Provider Identifier
1811533367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 31007042A
- Practice address
- 1329 Applegate LN
Clarksville, IN 47129-9612 - Phone
- (502) 633-1007
- Fax
- (502) 437-0624
- NPI assigned
- Nov 20, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 31007042A | IN | Primary |
Addresses
Primary practice location
1329 Applegate LN
Clarksville, IN 47129-9612
Mailing address
90 Howard Dr
Shelbyville, KY 40065-8138
Phone (502) 633-1007
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31007042A | IN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1574208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1574208000000",
"number": "1811533367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 HOWARD DR",
"city": "SHELBYVILLE",
"state": "KY",
"postal_code": "400658138",
"telephone_number": "502-633-1007",
"fax_number": "502-437-0624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1329 APPLEGATE LN",
"city": "CLARKSVILLE",
"state": "IN",
"postal_code": "471299612",
"telephone_number": "502-633-1007",
"fax_number": "502-437-0624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COSTIN",
"first_name": "KRISTYN",
"middle_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-20",
"last_updated": "2019-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IN",
"license": "31007042A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clarksville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.