1487053567 NPI number — KRISTEN HILL DPT

Table of content: KRISTEN HILL DPT (NPI 1487053567)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487053567 NPI number — KRISTEN HILL DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HILL
Provider First Name:
KRISTEN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PIFER
Provider Other First Name:
KRISTIN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1487053567
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/25/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7310 RITCHIE HWY
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
GLEN BURNIE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21061-3065
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-766-4047
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
850 S VALLEY FORGE RD UNIT A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LANSDALE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19446-4261
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
267-649-7658
Provider Business Practice Location Address Fax Number:
267-263-2997
Provider Enumeration Date:
08/14/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  25150 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT030100 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 286923 . This is a "JOHNS HOPKINS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 374295ZAVL . This is a "MEDICARE PTAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0849758 00 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8318150 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: T2080095 . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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