Individual provider Active NPI

Kristin Rae Porter

  • Obstetrics & Gynecology Nurse Practitioner
  • Bowie, MD
National Provider Identifier
1366053217
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
R178637 Issued in MD
Practice address
3060 Mitchellville Rd Ste 210
Bowie, MD 20716-3969
Phone
(410) 245-1563
NPI assigned
Aug 13, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X R178637 MD
Obstetrics & Gynecology Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LX0001X R178637 MD Primary

Addresses

Primary practice location

3060 Mitchellville Rd Ste 210
Bowie, MD 20716-3969

Mailing address

8110 Maple Lawn Blvd Ste 235
Fulton, MD 20759-2694
Phone (301) 340-8339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20210604000065 DC Practitioner - Nurse Practitioner 8820497241 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Womens Care LLCGroup PAC ID 4880582741, 281 clinicians

Practice addresses (Care Compare)

11200 Rockville Pike
Suite 205
North Bethesda, MD 20852-3103
Phone (301) 881-3260

Merit-based Incentive Payment System (MIPS)

Final score
43.1 of 100Reported as group
Quality
7.9
Improvement activities
40
Cost
79.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Women'S Care, L.L.C. Single Specialty CurrentSince Feb 26, 2021 Accepting new patients
Capital Womens Care LLC PastSince Oct 13, 2024 Accepting new patients

Locations

8110 Maple Lawn Blvd
Ste 235
Fulton, MD 20759

11200 Rockville Pike
Ste 205
Rockville, MD 20852
Phone (301) 249-4090

9711 Medical Center Dr
Ste 109
Rockville, MD 20850
Phone (301) 762-5501

Interoperability endpoints

  • Direct secure messaging: kristin.porter.p1@direct.cwcare.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1366053217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 MAPLE LAWN BLVD STE 235",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592694",
            "telephone_number": "301-340-8339",
            "fax_number": "301-340-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 MITCHELLVILLE RD STE 210",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163969",
            "telephone_number": "410-245-1563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "KRISTIN",
        "middle_name": "RAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-13",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "MD",
            "license": "R178637",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "MD",
            "license": "R178637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

Verify at the official NPI Registry.