Individual provider Active NPI

Krista Lynn Iannetta, TSHH

  • Specialist
  • Watertown, NY
National Provider Identifier
1942550934
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Practice address
16783 Ives Street Road
Watertown, NY 13601
Phone
(315) 788-5377
Fax
(315) 788-5373
NPI assigned
Sep 17, 2012
Last updated
Sep 20, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

16783 Ives Street Road
Watertown, NY 13601

Mailing address

P.O. Box 831 128 West Main Street
Apartment 2;
Brownville, NY 13615-0831
Phone (315) 767-1707

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

NPI Registry JSON

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

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1942550934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 831 128 WEST MAIN STREET",
            "address_2": "APARTMENT 2;",
            "city": "BROWNVILLE",
            "state": "NY",
            "postal_code": "136150831",
            "telephone_number": "315-767-1707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16783 IVES STREET ROAD",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "13601",
            "telephone_number": "315-788-5377",
            "fax_number": "315-788-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNETTA",
        "first_name": "KRISTA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "TSHH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-17",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.