Individual provider Active NPI

Kristin Marie Anders, PA-C

  • Physician Assistant
  • Hendersonville, TN
National Provider Identifier
1114673936
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4910 Issued in TN
Practice address
353 New Shackle Island Rd Ste 140C
Hendersonville, TN 37075-2366
Phone
(615) 826-5664
NPI assigned
Mar 2, 2022
Last updated
Apr 25, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4910 TN Primary

Addresses

Primary practice location

353 New Shackle Island Rd Ste 140C
Hendersonville, TN 37075-2366

Mailing address

353 New Shackle Island Rd Ste 140C
Hendersonville, TN 37075-2366
Phone (615) 826-5664

Other practice location 1

4220 Harding Pike Ste 500
Nashville, TN 37205-2005
Phone (615) 222-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20220901000790 TN Practitioner - Physician Assistant 9436533916 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Thomas Medical PartnersGroup PAC ID 1557269354, 588 clinicians

Practice addresses (Care Compare)

300 20TH Ave N
Nashville, TN 37203-2131
Phone (615) 284-1400

4220 Harding Pike
Nashville, TN 37205-2005
Phone (615) 222-6977

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4910TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Thomas Medical Partners CurrentSince May 1, 2023 Accepting new patients

Locations

300 20th Ave N
Fl 9
Nashville, TN 37203

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1114673936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 NEW SHACKLE ISLAND RD STE 140C",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752366",
            "telephone_number": "615-826-5664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 NEW SHACKLE ISLAND RD STE 140C",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752366",
            "telephone_number": "615-826-5664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4220 Harding Pike Ste 500",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372052005",
            "country_code": "US",
            "telephone_number": "615-222-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERS",
        "first_name": "KRISTIN",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-02",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, TN

Sources for this page

Verify at the official NPI Registry.