Individual provider Active NPI

Krista Andersen, M.D.

  • Pediatrics Physician
  • Plantation, FL
National Provider Identifier
1932461217
Registry record updated Jul 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME146983 Issued in FL
Practice address
9611 W Broward Blvd
Plantation, FL 33324-2334
Phone
(954) 424-7000
NPI assigned
Jun 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.125955 OH
Pediatrics Physician 208000000X ME146983 FL Primary

Addresses

Primary practice location

9611 W Broward Blvd
Plantation, FL 33324-2334

Mailing address

900 S Pine Island Rd Ste 800
Plantation, FL 33324-3923
Phone (813) 699-3995

Other practice location 1

4972 Town Center Pkwy Unit 301
Jacksonville, FL 32246-8596
Phone (904) 642-6100

Other practice location 2

901 E Bloomingdale Ave # 501
Brandon, FL 33511-8118
Phone (813) 699-3995

Other identifiers 1

IdentifierTypeStateIssuer
108043500MedicaidFL

Other names 1

  • Krista Karn Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address krista.andersen@pedsassoc.eclinicaldirectplus.com Direct

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME146983FLMDPediatrics Physician
35.125955OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Medical Center of Akron Past Accepting new patients
Children'S Hospital Medical Center of Akron Pediatrics Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688342400000",
    "number": "1932461217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD STE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243923",
            "telephone_number": "813-699-3995",
            "fax_number": "813-315-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9611 W BROWARD BLVD",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333242334",
            "telephone_number": "954-424-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4972 Town Center Pkwy Unit 301",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322468596",
            "country_code": "US",
            "telephone_number": "904-642-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 E Bloomingdale Ave # 501",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335118118",
            "country_code": "US",
            "telephone_number": "813-699-3995",
            "fax_number": "813-315-1625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSEN",
        "first_name": "KRISTA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-12",
        "last_updated": "2023-07-03",
        "certification_date": "2023-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.125955",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME146983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "108043500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krista.andersen@pedsassoc.eclinicaldirectplus.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "901 E Bloomingdale Ave # 501",
            "city": "Brandon",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335118118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTA",
            "last_name": "KARN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Plantation, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.