Active NPI
Kristyana Wichert
- Licensed Practical Nurse
- Boardman, OH
National Provider Identifier
1972021590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- LPN.163182.MEDS-IV
- Practice address
- 920 Boardman Canfield Rd
Boardman, OH 44512 - Phone
- (330) 259-8813
- NPI assigned
- Sep 4, 2017
- Last updated
- Sep 4, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | LPN.163182.MEDS-IV | OH | Primary |
Addresses
Primary practice location
920 Boardman Canfield Rd
Boardman, OH 44512
Mailing address
98 Westchester Drive
Austintown, OH 44515
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
| License | State | Type | Specialty |
|---|---|---|---|
| LPN.163182.MEDS-IV | OH | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Path Recovery, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Substance Abuse Rehabilitation Facility
- Boardman, OH
- NPI 1124558580
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1504483200000",
"number": "1972021590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "98 WESTCHESTER DRIVE",
"city": "AUSTINTOWN",
"state": "OH",
"postal_code": "44515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 BOARDMAN CANFIELD RD",
"city": "BOARDMAN",
"state": "OH",
"postal_code": "44512",
"telephone_number": "330-259-8813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICHERT",
"first_name": "KRISTYANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-09-04",
"last_updated": "2017-09-04",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "LPN.163182.MEDS-IV",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boardman, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.