Kristine Renee Maggi, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2412 Issued in NE

Practice address

2091 Box Butte Ave Ste 700
Alliance, NE 69301-4458

Phone

(308) 762-7244

Fax

(308) 761-1249

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: kmaggi@bbgh.securechart.com

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1952411647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 W 57TH ST",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826016445",
            "telephone_number": "307-871-9300",
            "fax_number": "855-733-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2091 BOX BUTTE AVE STE 700",
            "city": "ALLIANCE",
            "state": "NE",
            "postal_code": "693014458",
            "telephone_number": "308-762-7244",
            "fax_number": "308-761-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGGI",
        "first_name": "KRISTINE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WY",
            "license": "290",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NE",
            "license": "2412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "311835",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "970029372",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Line, OT
• Stephanie Luke
• Ashly Nicole Lunbery
• Brittany Michelle Macdonald
• Charles Maddox, PHARMD
• Trevor Malewski
• Isaias Mancias
• Crystal Ruby Martinez Garza
• Erik Mashek
• Summer Mashek

• Physician Assistant in Alliance, NE
• Providers in Alliance, NE by specialty
• Physician Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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.