Individual provider Active NPI

Kristin N Esenwein, FNP

  • Family Nurse Practitioner
  • Enterprise, AL
National Provider Identifier
1861052953
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-181535 Issued in AL
Practice address
805 E Lee St Ste B
Enterprise, AL 36330-2477
Phone
(334) 794-2718
NPI assigned
Jun 19, 2019
Last updated
Aug 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11002660 FL
Family Nurse Practitioner 363LF0000X 1-181535 AL Primary

Addresses

Primary practice location

805 E Lee St Ste B
Enterprise, AL 36330-2477

Mailing address

805 E Lee St Ste B
Enterprise, AL 36330-2477
Phone (334) 794-2718

Other practice location 1

520 John D Odom Rd
Dothan, AL 36303-9461
Phone (334) 794-2718

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20210827001317 AL Practitioner - Nurse Practitioner 6406251586 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allervie Health, Professional CorporationGroup PAC ID 1254358310, 15 clinicians

Practice addresses (Care Compare)

504 Brookwood Blvd
Birmingham, AL 35209-6802
Phone (205) 871-9661

805 E Lee St
Suite B
Enterprise, AL 36330-2477
Phone (334) 694-0890

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN11002660FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Allergist of Florida LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: esenwein.kristin.005.0090427@avh.meditab.direct-ci.com
  • Direct secure messaging: esenwein.kristin.009.0090427@avh.meditab.direct-ci.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1861052953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 E LEE ST STE B",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302477",
            "telephone_number": "334-794-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 E LEE ST STE B",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302477",
            "telephone_number": "334-794-2718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 John D Odom Rd",
            "address_purpose": "LOCATION",
            "city": "Dothan",
            "state": "AL",
            "postal_code": "363039461",
            "country_code": "US",
            "telephone_number": "334-794-2718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESENWEIN",
        "first_name": "KRISTIN",
        "middle_name": "N",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2022-08-15",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11002660",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-181535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

Verify at the official NPI Registry.