Christina L Haverstock, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2008-00444 Issued in NC

Practice address

510 N Elam Ave
Suite 303
Greensboro, NC 27403-1150

Phone

(336) 632-9272

Fax

(336) 632-1411

NPI assigned

Jan 4, 2008

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

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Dermatology

Education

State University of New York at Buffalo School of Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Specialists PAGroup PAC ID 3577522143, 7 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.93 of 100Reported as group

Quality

84.13

Promoting interoperability

100

Improvement activities

40

Cost

78.96

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/d229eaa4-39ac-4ce1-9bf0-8c3742977a5b/

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.

• Dermatology Specialists PA

  • Dermatology Physician
  • Greensboro, NC
  • NPI 1033195789
  Medicare reassignment Care Compare group
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  NPD (past)

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

{
    "created_epoch": "1199404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521676800000",
    "number": "1104001585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 N ELAM AVE",
            "address_2": "SUITE 303",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031150",
            "telephone_number": "336-632-9272",
            "fax_number": "336-632-1411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N ELAM AVE",
            "address_2": "SUITE 303",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031150",
            "telephone_number": "336-632-9272",
            "fax_number": "336-632-1411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVERSTOCK",
        "first_name": "CHRISTINA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-04",
        "last_updated": "2018-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "2008-00444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Haven Group Homes
• Haven Group Homes
• Haven Health
• Haven of Hearts Inc
• Havenpath Supportive Living LLC
• Diane Fuller Hawes, MD
• Thomas Nelson Hawken, M.D.
• Angela Hawkes, M.D.
• Elbert Hawkins III, PH.D., NCC, LCMHC-A
• Kaylen Hawkins

• Dermatology Physician in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.