Tara Kristiansen, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.025406 Issued in IL

Practice address

165 E Plank Rd
Sycamore, IL 60178-8757

Phone

(844) 599-3700

NPI assigned

Jul 2, 2022

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

Medicare fee-for-service enrollment

Enrolled in IL

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tara.kristiansen.p1@direct.gefcc.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Des Plaines, IL
  • NPI 1982783692
  Medicare reassignment NPD
• Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
  • NPI 1699701383
  NPD
• Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Bloomingdale, IL
  • NPI 1881773232
  NPD

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

{
    "created_epoch": "1656720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656720000000",
    "number": "1902539463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 E PLANK RD",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601788757",
            "telephone_number": "502-551-7002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 E PLANK RD",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601788757",
            "telephone_number": "844-599-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRISTIANSEN",
        "first_name": "TARA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-02",
        "last_updated": "2022-07-02",
        "certification_date": "2022-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.025406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven Anthony Koos, MD DDS
• Carrie L Kopala, PA-C
• Vera Kotelnikova
• Brianna Kraft, ATC
• Matthew Kraft, ATC
• Bryan M Kruskol, DO
• Kristin Kucala, BS
• Jessica Louise Kudia, PTA
• Karen L Kuhn, RPH
• Steven R Kuhn, PA

• Family Nurse Practitioner in Sycamore, IL
• Providers in Sycamore, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2022; 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.