KRISTIN MARIE GARDON (NP) – Family Nurse Practitioner, NPI 1366933608

KRISTIN MARIE GARDON (NP) is a healthcare provider. based in Green bay, Wisconsin. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 8502-33 (WI). The NPI Number for KRISTIN MARIE GARDON (NP) is 1366933608

Main info

Female
8 Years Of Experience
Accepts Medicare Assignment
Name
KRISTIN MARIE GARDON (NP)
NPI
1366933608
Phone
(920) 433-8586
Address
835 S. VAN BUREN ST.
Enumeration Date
22 May 2018
Last Update Date
16 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9204964700
Graduation Year
2018 (8 years ago)
PAC ID
3779832902
Group Practice PAC ID
5799694675
Professional Enrollment ID
I20180822000865
Address ID
WI543045252GR2502XAVEX400

Contacts

Secure Messaging
kgardon15578@ewd.direct.hshs.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness85
Years active:8State licenses:2Other namesUpdated within 12 months

6,035 NURSE PRACTITIONER in WI

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Provider Addresses for KRISTIN MARIE GARDON (NP)

  • Saint Vincent Hospital, 835, South Van Buren Street, Astor, Green Bay, Brown County, Wisconsin, 54307, United States

    GREEN BAY, WI 54301

    Phone: (920) 433-8586

    Fax: (920) 884-5306

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $65.

Total Amount is formed as General ($65) + Research ($0) + Ownership ($0) = $65.

Last reported payment date: 2024-03-20 • Largest payer in this snapshot: Organogenesis Inc. ($38).

Total Amount

$65

General + Research + Ownership

Payments

2

Total payment records

General Amount

$65

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-20

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-08-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180822000865INurse PractitionerWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 54301)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5799694675View full group profile
NameSpecialtyState
P O D I A T R YWI
-WI
-WI
Family Practice, Sports MedicineWI
-OH
Physical Therapist In Private PracticeWI
-WI
-WI
Internal Medicine, HospitalistWI
-WI

Reviews

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Frequently asked questions

How is KRISTIN MARIE GARDON (NP) identified in CMS data?
CMS-hosted NPPES data lists KRISTIN MARIE GARDON (NP) with NPI 1366933608.
Does the file indicate KRISTIN MARIE GARDON (NP) is practicing under active NPI?
Directory data currently reports KRISTIN MARIE GARDON (NP) as active.
What taxonomy line describes KRISTIN MARIE GARDON (NP)?
For research purposes, treat KRISTIN MARIE GARDON (NP) as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect KRISTIN MARIE GARDON (NP) on a map?
Expect Green Bay, Wisconsin as a primary anchor for KRISTIN MARIE GARDON (NP) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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