Individual provider Active NPI

Nicole Santos Kraese, FNP-BC

  • Family Nurse Practitioner
  • Ridgefield, CT
National Provider Identifier
1942501473
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8135 Issued in CT
Practice address
109 Danbury Rd Ste 4
Ridgefield, CT 06877-4109
Phone
(203) 947-6981
NPI assigned
Nov 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 578574-1 NY
Registered Nurse 163W00000X 089130 CT
Family Nurse Practitioner 363LF0000X F343366-1 NY
Family Nurse Practitioner 363LF0000X 8135 CT Primary

Addresses

Primary practice location

109 Danbury Rd Ste 4
Ridgefield, CT 06877-4109

Mailing address

5 Delta Ave
Danbury, CT 06810-7501
Phone (203) 312-3571

Other practice location 1

125 White Bridge Rd
Middletown, NY 10940-7319
Phone (203) 312-3571

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
089130CTMDRegistered Nurse
578574-1NYMDRegistered Nurse
F343366-1NYMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1942501473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 DELTA AVE",
            "city": "DANBURY",
            "state": "CT",
            "postal_code": "068107501",
            "telephone_number": "203-312-3571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 DANBURY RD STE 4",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774109",
            "telephone_number": "203-947-6981"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 White Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "NY",
            "postal_code": "109407319",
            "country_code": "US",
            "telephone_number": "203-312-3571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRAESE",
        "first_name": "NICOLE",
        "middle_name": "SANTOS",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-15",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "578574-1",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CT",
            "license": "089130",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F343366-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "8135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; 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.