Active NPI
Krisstina Clair Davis
- Occupational Therapy Assistant
- Durham, NC
National Provider Identifier
1366024671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- Practice address
- 3420 Wake Forest Rd
Durham, NC 27703-3522 - Phone
- (919) 596-9464
- NPI assigned
- Apr 26, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | Primary |
Addresses
Primary practice location
3420 Wake Forest Rd
Durham, NC 27703-3522
Mailing address
3420 Wake Forest Rd
Durham, NC 27703-3522
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13847 | Medicaid | NC |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | jhall@elevationrehab.com |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619395200000",
"number": "1366024671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3420 WAKE FOREST RD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277033522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3420 WAKE FOREST RD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277033522",
"telephone_number": "919-596-9464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "KRISSTINA CLAIR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-26",
"last_updated": "2021-04-26",
"certification_date": "2021-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "13847",
"state": "NC"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "jhall@elevationrehab.com",
"affiliation": "N",
"address_1": "3420 Wake Forest Rd",
"city": "Durham",
"state": "NC",
"country_code": "US",
"postal_code": "277033522",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.