Individual provider Active NPI

Kristi M Harrin, PSYD

  • Clinical Psychologist
  • Tampa, FL
National Provider Identifier
1104162882
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY8676 Issued in FL
Practice address
13039 W Linebaugh Ave
BLDG V Suite 101
Tampa, FL 33626-4483
Phone
(888) 531-1313
Fax
(888) 531-6035
NPI assigned
Dec 27, 2012
Last updated
Jan 2, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY8676 FL Primary

Addresses

Primary practice location

13039 W Linebaugh Ave
BLDG V Suite 101
Tampa, FL 33626-4483

Mailing address

13039 W Linebaugh Ave
BLDG V Suite 101
Tampa, FL 33626-4483
Phone (888) 531-1313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130116000005 FL Practitioner - Clinical Psychologist 3375796774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Achieve Wellness Group LLCGroup PAC ID 7113084187, 4 clinicians

Practice addresses (Care Compare)

13039 W Linebaugh Ave
Tampa, FL 33626-4483

13039 W Linebaugh Ave BLDG V
Suite 101
Tampa, FL 33626-4483
Phone (352) 515-6914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Achieve Wellness Group LLC Clinical CurrentSince Dec 5, 2012 Accepting new patients
Darlene Williams PH D PA Clinical Past Accepting new patients

Locations

13039 W Linebaugh Ave
Ste 101
Tampa, FL 33626
Phone (352) 515-6914

Networks

  • Freedom Health HMO Network

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.

NPI Registry JSON

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1104162882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13039 W LINEBAUGH AVE",
            "address_2": "BLDG V SUITE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336264483",
            "telephone_number": "888-531-1313",
            "fax_number": "888-531-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13039 W LINEBAUGH AVE",
            "address_2": "BLDG V SUITE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336264483",
            "telephone_number": "888-531-1313",
            "fax_number": "888-531-6035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIN",
        "first_name": "KRISTI",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-27",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY8676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.