Krystal Kay Lavine

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71008330A Issued in IN

Practice address

114 N Washington St
Bourbon, IN 46504-1623

Phone

(574) 335-7850

Fax

(574) 335-0755

NPI assigned

May 1, 2018

Last updated

Oct 3, 2024By the provider in NPPES

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 2

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Saint Joseph Regional Medical Center IncGroup PAC ID 8325950843, 137 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring Home health agency, Kokomo, IN, CCN 157586
• Clinical Home Health Care Home health agency, Demotte, IN, CCN 157240
• Saint Joseph Regional Medical Center - Plymouth Hospital, Plymouth, IN, CCN 150076

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: klavine1141710@direct.trinity-health.org

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.

• Saint Joseph Regional Medical Center, Inc.

  dba Saint Joseph Medical Group

  • Pulmonary Disease Physician
  • Plymouth, IN
  • NPI 1225082878

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Saint Joseph Regional Medical Center- Plymouth Campus Inc

  dba Saint Joseph Foot and Ankle Sports Medicine Institute Plymouth

  • Family Medicine Physician
  • Plymouth, IN
  • NPI 1538585187
  NPD (past)

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

• Clinical Management Services, Inc.

  • Home Health Agency
  • Demotte, IN
  • NPI 1306898390
  Care Compare affiliation
• Community Home Health Network of Indiana, LLC

  dba Elara Caring

  • Home Health Agency
  • Kokomo, IN
  • NPI 1346255940
  Care Compare affiliation
• Saint Joseph Regional Medical Center- Plymouth Campus Inc

  • General Acute Care Hospital
  • Plymouth, IN
  • NPI 1174571129
  Care Compare affiliation

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1821586207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 HOLY CROSS PKWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 N WASHINGTON ST",
            "city": "BOURBON",
            "state": "IN",
            "postal_code": "465041623",
            "telephone_number": "574-335-7850",
            "fax_number": "574-335-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVINE",
        "first_name": "KRYSTAL",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71008330A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300020124",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "1102236362",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephen F Cullison, D.D.S.
• Jennifer Robyn Friberg, N.P.
• JMRX, PC (Bourbon Pharmacy)
• Barbara Jane Kunnen, MS, RN, FNP-C
• Melissa Danielle Lattimore
• Nicole L. Christy DDS PC (Bourbon Family Dentistry)
• Jennifer Norman, MSW
• Sherry Faye Pyke, RN
• John M Reichert, RPH, MPA
• Rhonda Miller's Adult Respit Care

• Family Nurse Practitioner in Bourbon, IN
• Providers in Bourbon, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.