Active NPI
Kristin Elizabeth Maple, PH. D.
- Clinical Neuropsychologist
- Medford, OR
National Provider Identifier
1174290415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Neuropsychologist
- License
- 3428
- Practice address
- 837 Alder Creek Dr
Medford, OR 97504-8900 - Phone
- (541) 608-3878
- Fax
- (541) 608-3880
- NPI assigned
- Aug 25, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3428 | OR | |
| Clinical Neuropsychologist | 103G00000X | 3428 | OR | Primary |
Addresses
Primary practice location
837 Alder Creek Dr
Medford, OR 97504-8900
Mailing address
837 Alder Creek Dr
Medford, OR 97504-8900
Phone (541) 608-3878
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629849600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629849600000",
"number": "1174290415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "837 ALDER CREEK DR",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975048900",
"telephone_number": "541-608-3878",
"fax_number": "541-608-3880"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "837 ALDER CREEK DR",
"city": "MEDFORD",
"state": "OR",
"postal_code": "975048900",
"telephone_number": "541-608-3878",
"fax_number": "541-608-3880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAPLE",
"first_name": "KRISTIN",
"middle_name": "ELIZABETH",
"credential": "PH. D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-25",
"last_updated": "2021-08-25",
"certification_date": "2021-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "3428",
"primary": false
},
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "OR",
"license": "3428",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.