Individual provider Active NPI

Kristin Marie Trevor, FNP

  • Nurse Practitioner
  • Redding, CA
National Provider Identifier
1043442361
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NP95013428 Issued in CA
Practice address
1255 Liberty St
Redding, CA 96001-0814
Phone
(530) 246-2467
Fax
(530) 242-9460
NPI assigned
Aug 20, 2009
Last updated
Dec 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NP95013428 CA Primary

Addresses

Primary practice location

1255 Liberty St
Redding, CA 96001-0814

Mailing address

1255 Liberty St
Redding, CA 96001-0814
Phone (530) 246-2467

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20200110000671 CA Practitioner - Nurse Practitioner 1759406408 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1255 Liberty St
Redding, CA 96001-0814
Phone (530) 246-2467

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.52 of 100Reported as group
Quality
92.31
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95013428CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Shasta Orthopedics & Sports Medicine a Medical Corporation CurrentSince Dec 4, 2019 Accepting new patients
Apogee Outpatient Surgery Center Past Accepting new patients

Locations

1255 Liberty St
Redding, CA 96001
Phone (530) 224-2226

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1043442361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 LIBERTY ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010814",
            "telephone_number": "530-246-2467",
            "fax_number": "530-242-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 LIBERTY ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010814",
            "telephone_number": "530-246-2467",
            "fax_number": "530-242-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVOR",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-20",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NP95013428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.