Individual provider Active NPI

Kristin Davidson Burkhardt

  • Adult Health Nurse Practitioner
  • Pasadena, MD
National Provider Identifier
1376832584
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R165717 Issued in MD
Practice address
518 Edgewater Rd
Pasadena, MD 21122-5632
Phone
(443) 812-9735
Fax
(443) 295-3522
NPI assigned
Mar 29, 2011
Last updated
Oct 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R165717 MD Primary

Addresses

Primary practice location

518 Edgewater Rd
Pasadena, MD 21122-5632

Mailing address

518 Edgewater Rd
Pasadena, MD 21122-5632
Phone (443) 812-9735

Other names 1

  • Kristin Jennifer Davidson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20110922000057 MD Practitioner - Nurse Practitioner 8820269947 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Personal Physician Care, LLCGroup PAC ID 3274683289, 13 clinicians

Practice addresses (Care Compare)

518 Edgewater Rd
Pasadena, MD 21122-5632
Phone (443) 812-9735

6334 Cedar LN
Suite 103
Columbia, MD 21044-4172
Phone (410) 531-2355

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Personal Physician Care, LLC CurrentSince Sep 10, 2018 Accepting new patients
KJB Healthcare LLC Adult Health CurrentSince Aug 28, 2025 Accepting new patients

Locations

711 Maiden Choice Ln
Catonsville, MD 21228
Phone (410) 247-5602

6334 Cedar Ln
Ste 103
Columbia, MD 21044
Phone (410) 531-2355

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1301356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1376832584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 EDGEWATER RD",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211225632",
            "telephone_number": "443-812-9735",
            "fax_number": "443-295-3522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 EDGEWATER RD",
            "city": "PASADENA",
            "state": "MD",
            "postal_code": "211225632",
            "telephone_number": "443-812-9735",
            "fax_number": "443-295-3522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURKHARDT",
        "first_name": "KRISTIN",
        "middle_name": "DAVIDSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-29",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R165717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "DAVIDSON",
            "middle_name": "JENNIFER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pasadena, MD

Sources for this page

Verify at the official NPI Registry.