KRISTEN NICOLE MASSEY (NPI# 1003159450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003159450 |
| Entity Type | Individual |
| Full Name | KRISTEN NICOLE MASSEY |
| Credential | APN |
| Practice Address |
4017 State Route 159 Ste 101 Smithton IL 62285 |
| Mailing Address |
4017 State Route 159 Ste 101 Smithton IL 62285-2510 |
| Practice Telephone | 6182572875 |
| Practice Fax Number | 6182572895 |
| Mailing Telephone | 6182572875 |
| Mailing Fax Number | 6182572895 |
| Enumeration Date | 2013-04-04 |
| Last Update Date | 2019-11-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
209010341 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
209010341 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | IL LIC | 209010341 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4600 Memorial Dr, Ste. 360, Belleville, IL 622265368 | 6182227280 | 6182227281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083215495 | Kristen Fontela Massey | Physical Therapist | 3116 N Duke St, Durham, NC 27704-2102 | 2020-11-03 |
| 1811454424 | Kristen Nicole Massey | Nurse Practitioner | 2490 Parr Ave Ste 3, Dyersburg, TN 38024-2032 | 2019-03-01 |
| 1770974545 | Kristen Massey | Counselor | 700 S Penn Ave, Bartlesville, OK 74003-3847 | 2015-02-14 |
| 1124098777 | Kristen M Massey | Nurse Practitioner | 3601 The Vanderbilt Clinic, Nashville, TN 37232-2013 | 2006-01-25 |
| Street Address |
4017 STATE ROUTE 159 STE 101 |
| City | SMITHTON |
| State | IL |
| Zip Code | 62285 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144730128 | Ashley Marie Hynes | Physician Assistant | 4059 Chestnut Oak Dr, Smithton, IL 62285 | 2017-10-04 |
| 1326419912 | Smithton Pharmacy Professional Corporation | Pharmacy | 3981 State Route 159, Smithton, IL 62285 | 2015-10-08 |
| 1295159184 | Ca Group, LLC | Internal Medicine | 4017 Illinois Route 159, Suite 101, Smithton, IL 62285 | 2014-02-12 |
| 1760819676 | Msa Alliance, LLC | Family Medicine | 4017 Illinois Route 159, Suite 101, Smithton, IL 62285 | 2013-10-09 |
| 1619280112 | Pc Associates, LLC | Family Medicine | 4017 Illinios Rt. 159, Ste 101, Smithton, IL 62285 | 2010-07-26 |
| 1225174642 | Amy Y Pfingsten | Speech-Language Pathologist | 215 Eugenia, Smithton, IL 62285 | 2007-01-30 |
| 1265526818 | Beverly Enterprises - Illinois, Inc. | Skilled Nursing Facility | 107 S. Lincoln, Smithton, IL 62285 | 2006-10-03 |
| 1316903008 | Thomas Gregory Bircher | Dentist | 504 North Main Street, Smithton, IL 62285 | 2006-04-22 |
| 1003285560 | Mattison N Perez | Physician Assistant | 4017 Illinois State Route 159, Suite 101, Smithton, IL 62285 | 2015-09-15 |
| 1407962517 | Bircher Family Dental Care PC | Dentist | 504 N Main St, Smithton, IL 62285 | 2006-08-22 |
| Find all providers in zip 62285 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851998553 | Melissa Litwin | Nurse Practitioner | 9127 Burlington Ave, Brookfield, IL 60513-1939 | 2020-10-06 |
| 1932724200 | Tatyana Menaker | Nurse Practitioner | 2958 West Devon Ave, Chicago, IL 60659 | 2020-06-12 |
| 1518506625 | Lila Macalinga Rivera | Nurse Practitioner | 17w335 16th St, Oakbrook Terrace, IL 60181-4030 | 2020-01-06 |
| 1922642495 | Christine Nacar | Nurse Practitioner | 1232 Le Moyne Ave, Romeoville, IL 60446-4180 | 2019-10-29 |
| 1144871344 | Wensheng Tracy Wu | Nurse Practitioner | 1555 Barrington Rd Ste 1200, Hoffman Estates, IL 60169-5036 | 2019-09-27 |
| 1881245314 | Mkbb LLC | Nurse Practitioner | 1212 E Algonquin Rd, Algonquin, IL 60102-5446 | 2019-09-25 |
| 1225681455 | Jinu Joss | Nurse Practitioner | 9939 N Warren Oval, Niles, IL 60714-1044 | 2019-07-17 |
| 1659830057 | Ginger Dean | Nurse Practitioner | 2843 Chicago Rd, South Chicago Heights, IL 60411-4736 | 2019-03-15 |
| 1770048910 | Amanda K Honchell I | Nurse Practitioner | 401 W Madison St, Mount Carroll, IL 61053-9485 | 2019-02-01 |
| 1548725799 | Grace Nwaka Wabomnor | Nurse Practitioner | 17 E Grandview Dr, South Holland, IL 60473-1099 | 2019-02-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.