Individual provider Active NPI

Kristen Sikora

  • Specialist
  • Peabody, MA
National Provider Identifier
1972978997
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1109563 Issued in MA
Practice address
3 Bourbon St
Peabody, MA 01960-1339
Phone
(803) 493-8323
NPI assigned
Dec 2, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1109563 MA Primary

Addresses

Primary practice location

3 Bourbon St
Peabody, MA 01960-1339

Mailing address

7 Mulberry Dr
Peabody, MA 01960-4629
Phone (803) 493-8323

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
1109563MAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1972978997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 MULBERRY DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019604629",
            "telephone_number": "803-493-8323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 BOURBON ST",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601339",
            "telephone_number": "803-493-8323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIKORA",
        "first_name": "KRISTEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-02",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "1109563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; 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.