Individual provider Active NPI

Krystyna Badoni

  • Licensed Practical Nurse
  • Saginaw, MI
National Provider Identifier
1962900779
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
4703094883 Issued in MI
Practice address
3995 Fashion Square Blvd
Saginaw, MI 48603-1291
Phone
(989) 799-0410
NPI assigned
Jan 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703094883 MI Primary

Addresses

Primary practice location

3995 Fashion Square Blvd
Saginaw, MI 48603-1291

Mailing address

3995 Fashion Square Blvd
Saginaw, MI 48603-1291
Phone (989) 799-0410

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

State licenses

LicenseStateTypeSpecialty
4703094883MIMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1516924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516924800000",
    "number": "1962900779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3995 FASHION SQUARE BLVD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486031291",
            "telephone_number": "989-799-0410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3995 FASHION SQUARE BLVD",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486031291",
            "telephone_number": "989-799-0410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADONI",
        "first_name": "KRYSTYNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-26",
        "last_updated": "2018-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703094883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saginaw, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2018; 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.