Kristin Braveboy Haddock, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2601 Issued in SC

Practice address

420 Society Hill Dr Ste 100
Aiken, SC 29803-1731

Phone

(803) 648-7774

Fax

(803) 648-7490

NPI assigned

Feb 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

University of South Carolina School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aiken Professional Association LLCGroup PAC ID 0446430805, 55 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pruitthealth Home Health-Low Country Home health agency, Bluffton, SC, CCN 427123
• Trinity Home Health of Aiken Home health agency, Aiken, SC, CCN 427119
• Enhabit Home Health Aiken Home health agency, Columbia, SC, CCN 427128
• NHC Homecare Aiken Home health agency, Aiken, SC, CCN 427077
• Aiken Regional Medical Center Hospital, Aiken, SC, CCN 420082

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Aiken Professional Association, LLC

  • Internal Medicine Physician
  • Aiken, SC
  • NPI 1639479801
  Medicare reassignment Care Compare group NPD
• Aiken Professional Association LLC

  • Urgent Care Clinic/Center
  • Graniteville, SC
  • NPI 1457825846
  NPD

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

• Aiken Regional Medical Centers LLC

  • General Acute Care Hospital
  • Aiken, SC
  • NPI 1447437157
  Care Compare affiliation
• Aiken Regional Medical Centers LLC

  • General Acute Care Hospital
  • Aiken, SC
  • NPI 1467448498
  Care Compare affiliation
• Aiken Regional Medical Centers, LLC.

  • Neurological Surgery Physician
  • Aiken, SC
  • NPI 1942610928

  Hospital

  Care Compare affiliation
• Augusta Home Care Services, LLC

  • Home Health Agency
  • Aiken, SC
  • NPI 1316315278
  Care Compare affiliation
• Caresouth HHA Holdings of South Carolina, LLC

  • Home Health Agency
  • Aiken, SC
  • NPI 1033456918
  Care Compare affiliation
• NHC-Op LP

  • Home Health Agency
  • Aiken, SC
  • NPI 1003846734
  Care Compare affiliation
• Pruitthealth Home Health, Inc.

  • Home Health Agency
  • Bluffton, SC
  • NPI 1114267325
  Care Compare affiliation
• Pruitthealth Home Health, Inc.

  • Home Health Agency
  • Aiken, SC
  • NPI 1184167264
  Care Compare affiliation
• Pruitthealth Home Health, Inc.

  • Home Health Agency
  • Ladson, SC
  • NPI 1770008377
  Care Compare affiliation

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551916800000",
    "number": "1053384073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S. GULPH RD",
            "address_2": "ATT: IPM CREDENTIALING",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "803-648-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 SOCIETY HILL DR STE 100",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298031731",
            "telephone_number": "803-648-7774",
            "fax_number": "803-648-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HADDOCK",
        "first_name": "KRISTIN",
        "middle_name": "BRAVEBOY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2019-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "2601",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0888",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathy Livingston Gunter, CRNA
• Shreya Gupta, MD
• Brittany Shalaigh Gustavson, APRN, FNP-C
• Angelique C Gutierrez
• Muhammad Habib Ur Rehman, M.D.
• James L Hagan Sr., M.D.
• Cedrick Hair, PHARMD
• Mary L Halbritter, PA-C
• Alice Drannon Hale, DMD
• Dallas Hall, CCC-SLP

• Family Nurse Practitioner in Aiken, SC
• Providers in Aiken, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.