Individual provider Active NPI

Kristi A Nix, MD

  • Pediatrics Physician
  • Bend, OR
National Provider Identifier
1083740187
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD126239 Issued in OR
Practice address
815 SW Bond St
Bend, OR 97702-3593
Phone
(541) 382-4900
NPI assigned
Feb 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD126239 OR Primary

Addresses

Primary practice location

815 SW Bond St
Bend, OR 97702-3593

Mailing address

PO Box 6048
Bend, OR 97708-6048
Phone (541) 382-4900

Other identifiers 1

IdentifierTypeStateIssuer
500621974MedicaidOR

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address knix22069@directmsg.bmctotalcare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150615001538 OR Practitioner - Pediatric Medicine 4981595154 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Bend Memorial Clinic PC CurrentSince Sep 1, 2024 Accepting new patients
Bend Memorial Clinic PC CurrentSince Sep 1, 2024 Accepting new patients
Children'S Hospital & Regional Medical Center 2 Past Accepting new patients

Locations

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

815 SW Bond St
#100
Bend, OR 97702
Phone (541) 706-2525

815 SW Bond St
Bend, OR 97702
Phone (541) 382-4900

Interoperability endpoints

  • Direct secure messaging: knix22069@directmsg.bmctotalcare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1083740187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6048",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977086048",
            "telephone_number": "541-382-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 SW BOND ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977023593",
            "telephone_number": "541-382-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIX",
        "first_name": "KRISTI",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD126239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500621974",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knix22069@directmsg.bmctotalcare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "815 SW Bond St",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977023593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.