Individual provider Active NPI

Kristina Marie Washington, PA

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1295382059
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-10783 Issued in NC
Practice address
1237 Harding PL
Ste 3200
Charlotte, NC 28204
Phone
(704) 355-5375
NPI assigned
Aug 26, 2019
Last updated
Mar 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 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 0010-10783 NC Primary

Addresses

Primary practice location

1237 Harding PL
Ste 3200
Charlotte, NC 28204

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

10650 Park Rd
Ste 300
Charlotte, NC 28210-8538
Phone (704) 667-3925

Other practice location 2

1010 E Dixon Blvd
Shelby, NC 28152-6838
Phone (980) 487-2700

Other practice location 3

1090 NE Gateway Ct NE
Ste 201
Concord, NC 28025-2414
Phone (704) 403-7770

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address kwashington429866@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20191019000007 SC Practitioner - Physician Assistant 6406187665 Reassigns benefits to 1 organization
I20210305001310 NC Practitioner - Physician Assistant 6406187665 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeast Radiation Oncology Group, P.a.Group PAC ID 1254233950, 52 clinicians

Practice addresses (Care Compare)

200 Queens Rd
Charlotte, NC 28204-3264
Phone (704) 333-7376

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-10783NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Mar 15, 2021 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Mar 15, 2021 Accepting new patients
Carolinas Physicians Network Inc CurrentSince Mar 15, 2021 Accepting new patients
Hopehealth Inc CurrentSince Sep 16, 2019 Accepting new patients
Hopehealth, Inc CurrentSince Sep 16, 2019 Accepting new patients
The Charlotte-Mecklenburg Hospital Authority CurrentSince Mar 15, 2021 Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

10650 Park Rd
Ste 300
Charlotte, NC 28210
Phone (704) 667-3925

1237 Harding Pl
Ste 3200
Charlotte, NC 28204
Phone (704) 355-5375

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

14214 Ballantyne Lake Rd
Ste 300
Charlotte, NC 28277
Phone (704) 446-5070

1090 NE Gateway Ct NE
Ste 201
Concord, NC 28025
Phone (704) 403-7770

200 Medical Park Dr
Ste 250
Concord, NC 28025
Phone (704) 403-2740

1010 E Dixon Blvd
Shelby, NC 28152
Phone (980) 487-2700

360 N Irby St
Florence, SC 29501
Phone (843) 656-0353

600 E Palmetto St
Florence, SC 29506
Phone (843) 656-0390

Interoperability endpoints

  • Direct secure messaging: kwashington429866@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 11

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 6

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": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1295382059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 HARDING PL",
            "address_2": "STE 3200",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "704-355-5375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10650 Park Rd",
            "address_2": "Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-667-3925",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1010 E Dixon Blvd",
            "address_purpose": "LOCATION",
            "city": "Shelby",
            "state": "NC",
            "postal_code": "281526838",
            "country_code": "US",
            "telephone_number": "980-487-2700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1090 NE Gateway Ct NE",
            "address_2": "Ste 201",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280252414",
            "country_code": "US",
            "telephone_number": "704-403-7770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-26",
        "last_updated": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-10783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwashington429866@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 3200",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.