Kristyn Marie Ray Rhode, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

100 Brewster Blvd
Camp Lejeune, NC 28547-2575

Phone

(805) 575-5481

NPI assigned

Nov 28, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1669593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1396455655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4967 E NC 24 HWY",
            "city": "BEULAVILLE",
            "state": "NC",
            "postal_code": "285187647",
            "telephone_number": "805-575-5481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BREWSTER BLVD",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285472575",
            "telephone_number": "805-575-5481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHODE",
        "first_name": "KRISTYN",
        "middle_name": "MARIE RAY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-28",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "1222068",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Reeder, PH.D.
• Janice Michelle Rees, NP
• Lindsay Reinhardt, PH.D.
• Julio J. Rentas Reyes, M.D.
• Blake Matthew Reynolds, SOIDC
• Cory Riccio
• Leslie A Richardson, M.D.
• Laura Riebel
• William P Rieger, DDS
• Alfrea Tiese Riley Moore, RN

• Physician Assistant in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.