Kristen Marie Geraghty, R.N., N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

19850 Issued in CA

Practice address

UCLA Medl CNTR Oncology CNTR Bowyer Clinic
Box 956956, Ste 120, 200 Medl PLZ
Los Angeles, CA 90095-6956

Phone

(858) 449-8761

NPI assigned

Sep 28, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kristen Marie Gordon Former name

Medicare fee-for-service enrollment

Enrolled in CA

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, Registered Nurse

State licenses

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1861701666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UCLA MEDL CNTR ONCOLOGY CNTR BOWYER CLINIC",
            "address_2": "BOX 956956, STE 120, 200 MEDL PLZ",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900956956",
            "telephone_number": "858-449-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UCLA MEDL CNTR ONCOLOGY CNTR BOWYER CLINIC",
            "address_2": "BOX 956956, STE 120, 200 MEDL PLZ",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900956956",
            "telephone_number": "858-449-8761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERAGHTY",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "credential": "R.N., N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "19850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "GORDON",
            "middle_name": "MARIE",
            "credential": "R.N.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Nurse Practitioner in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; 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.