Kristine Elyssa Rork, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

6641 Issued in OH

Practice address

1 Perkins SQ
Akron, OH 44308-1063

Phone

(330) 543-4270

Fax

(330) 543-4271

NPI assigned

Feb 25, 2010

Last updated

Sep 15, 2015By the provider in NPPES

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

Other names 1

• Karistine Vandoran Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 1, 2020 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1267056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442275200000",
    "number": "1225350606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-543-4270",
            "fax_number": "330-543-4271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-543-4270",
            "fax_number": "330-543-4271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RORK",
        "first_name": "KRISTINE",
        "middle_name": "ELYSSA",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-25",
        "last_updated": "2015-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "OH",
            "license": "6641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARISTINE",
            "last_name": "VANDORAN",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lavish Roper
• Rachelle Roper
• Sergio Roper
• Mikayla Rorar, CNP
• Tanesha L Rorie, LPCC
• Ashley Laurin Rorrer
• Deidra E Rosario, LPN
• Jonathan P Roscoe, DMD
• Amanda F Rose, PSY.D.
• Heather C Rose, M.A.

• Clinical Child & Adolescent Psychologist in Akron, OH
• Providers in Akron, OH by specialty
• Clinical Child & Adolescent Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.