KRISTY FUNDORA (NPI# 1558816140) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558816140 |
| Entity Type | Individual |
| Full Name | KRISTY FUNDORA |
| Practice Address |
8835 Germantown Ave Philadelphia PA 19118-2718 |
| Practice Telephone | 2152488200 |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2017-05-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
SP016708 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | CRNP LICENSE NUMBER | SP016708 | 01 |
| PA | NURSING LICENSE | RN670943 | 01 |
| PA | PRESCRIPTIVE AUTHORITY NUMBER | 028272 | 01 |
| Street Address |
8835 GERMANTOWN AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19118-2718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487657656 | Mulki Giridhar Bhat | Anesthesiology | 8835 Germantown Ave, Philadelphia, PA 19118-2718 | 2005-05-23 |
| 1225645484 | Christina Rizzardi | Nurse Practitioner | 8835 Germantown Ave, Philadelphia, PA 19118-2718 | 2020-09-30 |
| 1518575257 | Jin Oh Cho | Podiatrist | 8835 Germantown Ave, Philadelphia, PA 19118-2718 | 2020-07-20 |
| 1881212074 | Ryan Jeffrey Hippler | Podiatrist | 8835 Germantown Ave, Philadelphia, PA 19118-2718 | 2020-07-14 |
| 1356960686 | Abdul Abel Walters | Student in an Organized Health Care Education/Training Program | 8835 Germantown Ave, Philadelphia, PA 19118-2718 | 2020-04-16 |
| 1821624990 | Amanda Stearns | Physician Assistant | 8835 Germantown Ave, Philadelphia, PA 19118-2718 | 2020-03-20 |
| 1306476924 | Tower Health Medical Group | Internal Medicine | 8835 Germantown Ave, Philadelphia, PA 19118-2718 | 2020-01-23 |
| 1285274969 | Chestnut Hill Clinic Company, LLC | Internal Medicine | 8835 Germantown Ave, Philadelphia, PA 19118-2718 | 2020-01-10 |
| 1679131619 | Reid Ashton Singer | Physician Assistant | 8835 Germantown Ave, Philadelphia, PA 19118-2718 | 2019-06-04 |
| 1730659707 | Alexander Mitchell | Nurse Practitioner | 8835 Germantown Ave, Philadelphia, PA 19118-2718 | 2018-12-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801380126 | Bridget Hirsch | Psychologist | 18 E Abington Avenue, Philadelphia, PA 19118 | 2018-06-20 |
| 1740719194 | Alyssa H Bloch | Speech-Language Pathologist | 8431 Germantown Avenue, Philadelphia, PA 19118 | 2017-06-08 |
| 1710344056 | Zachary Roberts | Physical Therapist | 19 West Highland Avenue, Philadelphia, PA 19118 | 2016-01-18 |
| 1164847810 | Judith Maxwell | Family Medicine | 415 West Mermaid Ln, Philadelphia, PA 19118 | 2014-03-04 |
| 1174963151 | Deborah Hope Cooper | Counselor | 22 E. Chestnut Hill Avenue, Samaritan Counseling Service, Philadelphia, PA 19118 | 2013-07-05 |
| 1730524349 | Breast-pump-rental.com | Durable Medical Equipment & Medical Supplies | 112 W Gravers Lane, Philadelphia, PA 19118 | 2013-05-09 |
| 1083964902 | Visionworks, Inc. | Eyewear Supplier (Equipment, not the service) | 7700 Crittenden Ave., Philadelphia, PA 19118 | 2012-09-18 |
| 1215286679 | Jessica M Steedle | Speech-Language Pathologist | 102 East Mermaid Lane, Philadelphia, PA 19118 | 2012-08-31 |
| 1083960124 | Fahad Malik Akhtar | Family Medicine | 8815 Germantown Avenue, 5th Floor, Philadelphia, PA 19118 | 2012-07-26 |
| 1992026793 | Valerie Mikula Hughes | Dentist | 9 E. Highland Ave, Philadelphia, PA 19118 | 2010-06-15 |
| Find all providers in zip 19118 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770199341 | Nicole Kassandra Carissimi | Nurse Practitioner | 1618 S 19th St, Philadelphia, PA 19145-1439 | 2020-09-19 |
| 1770192775 | Lisa Ghiloni | Nurse Practitioner | 6809 N 10th St, Philadelphia, PA 19126-2906 | 2020-07-26 |
| 1104440940 | Patricia Cecilia Castillo | Nurse Practitioner | 49204 Delaire Landing Rd, Philadelphia, PA 19114-5329 | 2020-06-06 |
| 1184271074 | Clement John | Nurse Practitioner | 3253 N 6th St, Philadelphia, PA 19140-5644 | 2019-08-25 |
| 1558915967 | Latoya Mohammed | Nurse Practitioner | 3300 Henry Ave Ste 3n, Philadelphia, PA 19129-1141 | 2019-07-25 |
| 1225427867 | Alison Ercole | Nurse Practitioner | 4301 Spruce St, Apt A 414, Philadelphia, PA 19104-4760 | 2015-01-20 |
| 1790195386 | Thomasean Britten | Nurse Practitioner | 449 Parker Ave, Philadelphia, PA 19128-4403 | 2014-05-05 |
| 1891048377 | Elizabeth Ann Milburn | Nurse Practitioner | 1528 Walnut St Ste 1414, Philadelphia, PA 19102-3610 | 2012-10-20 |
| 1336410851 | Justin Egoville | Nurse Practitioner | 80001 State Rd., Mhm Correctional Services, Mod II, Philadelphia, PA 19136-0000 | 2012-01-13 |
| 1396050720 | Dwayne M Toomer | Nurse Practitioner | 718 Addison St Apt E, Philadelphia, PA 19147-1353 | 2010-08-10 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19118 |
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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.