Individual provider Active NPI

Kristine Jean Simon, R.N., L.P.C.

  • Professional Counselor
  • Madison, WI
National Provider Identifier
1902103161
Registry record updated Feb 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4521-125 Issued in WI
Practice address
330 S Whitney Way
Suite Number 303
Madison, WI 53705-4638
Phone
(608) 212-5219
NPI assigned
Feb 23, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4521-125 WI Primary
Hospice Registered Nurse 163WH1000X 69991-030 WI

Addresses

Primary practice location

330 S Whitney Way
Suite Number 303
Madison, WI 53705-4638

Mailing address

1270 McMahon Dr
Sun Prairie, WI 53590-3810
Phone (608) 212-5219

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4521-125WIMDProfessional Counselor
69991-030WIMDHospice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1298419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298419200000",
    "number": "1902103161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 MCMAHON DR",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535903810",
            "telephone_number": "608-212-5219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S WHITNEY WAY",
            "address_2": "SUITE NUMBER 303",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537054638",
            "telephone_number": "608-212-5219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "KRISTINE",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "R.N., L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-23",
        "last_updated": "2011-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4521-125",
            "primary": true
        },
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "WI",
            "license": "69991-030",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.