Active NPI
Kristina Reavis, APN
- Acute Care Nurse Practitioner
- Pueblo, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- 995088
- Practice address
- 400 W 16TH St
Pueblo, CO 81003-2781 - Phone
- (719) 659-8141
- NPI assigned
- May 8, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 995088 | CO | |
| Acute Care Nurse Practitioner | 363LA2100X | 995088 | CO | Primary |
Addresses
Primary practice location
400 W 16TH St
Pueblo, CO 81003-2781
Mailing address
312 Michigan Ave
Manitou Springs, CO 80829-1637
Phone (719) 659-8141
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0 | Other | N/A |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Pueblo |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
400 W 16TH St
Pueblo, CO 81003-2745
Phone (719) 584-4921
4404 Barranca LN
Unit 101
Castle Rock, CO 80104-7419
Phone (720) 733-5260
Hospital & facility affiliations
- Parkview Medical Center, Inc
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 995088 | CO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poudre Valley Medical Group, LLC | Current | Accepting new patients | |
| Poudre Valley Medical Group, LLC | Current | Accepting new patients |
Locations
4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260
400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000
58 Club Manor Dr
Pueblo, CO 81008
Phone (719) 584-4045
1619 N Greenwood St
Ste 106
Pueblo, CO 81003
Phone (719) 595-7760
1600 N Grand Ave
Ste 430
Pueblo, CO 81003
Phone (719) 545-8240
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Loveland, CO
- NPI 1225356868
-
- General Practice Physician
- Loveland, CO
- NPI 1366763260
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Pueblo, CO
- NPI 1184263527
-
- General Acute Care Hospital
- Pueblo, CO
- NPI 1376183145
-
- General Acute Care Hospital
- Pueblo, CO
- NPI 1417596834
-
- General Acute Care Hospital
- Pueblo, CO
- NPI 1427689652
-
- General Acute Care Hospital
- Pueblo, CO
- NPI 1104881507
-
- General Acute Care Hospital
- Pueblo, CO
- NPI 1134751712
-
- General Acute Care Hospital
- Pueblo West, CO
- NPI 1821720681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588896000000",
"number": "1992327217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 MICHIGAN AVE",
"city": "MANITOU SPRINGS",
"state": "CO",
"postal_code": "808291637",
"telephone_number": "719-659-8141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 W 16TH ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810032781",
"telephone_number": "719-659-8141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REAVIS",
"first_name": "KRISTINA",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-08",
"last_updated": "2020-05-08",
"certification_date": "2020-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CO",
"license": "995088",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "CO",
"license": "995088",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "Pueblo",
"affiliation": "N",
"address_1": "400 W 16th St",
"city": "Pueblo",
"state": "CO",
"country_code": "US",
"postal_code": "810032781",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.