Kristina M Dibartolo, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

25819 Issued in SC

Practice address

90 Springview LN # a
Summerville, SC 29485-8153

Phone

(843) 832-9113

Fax

(843) 832-9114

NPI assigned

Nov 14, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BBICDD/Endpoint/BBICDD

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.

• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1073234928

  SC

  Medicare reassignment NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1366123739
  NPD
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1821205717
  NPD
• Carolina Children'S Clinic, LLC

  • Urgent Care Clinic/Center
  • Boiling Springs, SC
  • NPI 1649915216
  NPD (past)
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • Summerville, SC
  • NPI 1265690382
  NPD (past)
• Palmetto Primary Care Physicians, LLC

  • Family Medicine Physician
  • N Charleston, SC
  • NPI 1629017694
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646352000000",
    "number": "1033711981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 SPRINGVIEW LN # A",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858153",
            "telephone_number": "843-832-9113",
            "fax_number": "843-832-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 SPRINGVIEW LN # A",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294858153",
            "telephone_number": "843-832-9113",
            "fax_number": "843-832-9114"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 Alewife Brook Pkwy",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021381101",
            "country_code": "US",
            "telephone_number": "617-661-6422",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 Macy St",
            "address_purpose": "LOCATION",
            "city": "Amesbury",
            "state": "MA",
            "postal_code": "019133706",
            "country_code": "US",
            "telephone_number": "978-834-0300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIBARTOLO",
        "first_name": "KRISTINA",
        "middle_name": "M",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-14",
        "last_updated": "2022-03-04",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "25819",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2300900",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julianna Desumma
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• Dawn Marie Cameron Devaux, RN, PMHNP-BC
• Brae Dewalt
• Dialysis Clinic Inc
• Julianne Dicicco-Wiles, MS, CPS, ICPS
• Krista Dickerson
• Abigail Dickinson
• Renae Lynn Dietzel
• Dawn Marie Digennaro, LMSW

• All providers in Summerville, SC
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.