Kristin Michelle Powell Reavis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D76428 Issued in MD

Practice address

29 S Paca St
Baltimore, MD 21201-1771

Phone

(667) 214-1800

Fax

(410) 685-1971

NPI assigned

May 6, 2009

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

Other names 1

• Kristin Michelle Powell Former name

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

University of Maryland School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kaiser Foundation Health Plan of the Mid Atlantic States, IncGroup PAC ID 3779495858, 1,921 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kreavis86938@direct.umm.edu

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.

• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • Health Maintenance Organization
  • Annapolis, MD
  • NPI 1952461816

  DC, Family Medicine

  Medicare reassignment Care Compare group NPD
• University of Maryland Faculty Physicians Immediate Care, LLC

  • Urgent Care Clinic/Center
  • Columbia, MD
  • NPI 1972986271
  Medicare reassignment NPD
• University of Maryland Family Medicine Associates, P.a.

  • Specialist
  • Baltimore, MD
  • NPI 1053424994
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Mid Atlantic States, Inc

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Rockville, MD
  • NPI 1962108753
  NPD
• University of Maryland Family Medicine Associates, P.a.

  • Specialist
  • Baltimore, MD
  • NPI 1417764010
  NPD
• University of North Carolina at Chapel Hill

  • Anesthesiology Physician
  • Chapel Hill, NC
  • NPI 1780669200

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1063646974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 S PACA ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011771",
            "telephone_number": "667-214-1800",
            "fax_number": "410-685-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 S PACA ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011771",
            "telephone_number": "667-214-1800",
            "fax_number": "410-685-1971"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Unc Family Medicine",
            "address_2": "590 Manning Drive,CB7595",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275990001",
            "country_code": "US",
            "telephone_number": "919-966-3711",
            "fax_number": "919-966-6126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REAVIS",
        "first_name": "KRISTIN",
        "middle_name": "MICHELLE POWELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-06",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "156929",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D76428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "POWELL",
            "middle_name": "MICHELLE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Medicine Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.