Individual provider Active NPI

Kristin Erin Kavanagh, MD

  • Diagnostic Radiology Physician
  • Akron, OH
National Provider Identifier
1477832079
Registry record updated Oct 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
35.131057 Issued in OH
Practice address
1 Akron General Ave
Akron, OH 44307-2432
Phone
(330) 344-6000
NPI assigned
Aug 12, 2011
Last updated
Oct 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 35.131057 OH
Diagnostic Ultrasound Physician 2085U0001X 35.131057 OH
Diagnostic Radiology Physician 2085R0202X 35.131057 OH Primary

Addresses

Primary practice location

1 Akron General Ave
Akron, OH 44307-2432

Mailing address

9500 Euclid Ave
Cleveland, OH 44195-0001

Other practice location 1

1320 Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1070

Other practice location 2

981045 Nebraska Medical Ctr
Omaha, NE 68198-1045
Phone (402) 559-1018

Other identifiers 2

IdentifierTypeStateIssuer
35.131057OtherOHSTATE MEDICAL LICENSE
2013028506OtherMOSTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170620000302 OH Practitioner - Interventional RadiologyPractitioner - Interventional Pain ManagementPractitioner - Diagnostic Radiology 2163714346 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology, Interventional Pain Management
Education
University of Missouri, Kansas City, School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinic Medical Services CompanyGroup PAC ID 5698674653, 201 clinicians
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

1940 Town Park Blvd
Uniontown, OH 44685-7855
Phone (330) 896-5010

225 Elyria St
Lodi, OH 44254-1031
Phone (330) 948-1222

2420 Lake Ave
Ashtabula, OH 44004-4954
Phone (440) 997-2262

4125 Medina Rd
Akron, OH 44333-2483
Phone (330) 665-8000

4300 Allen Rd
Stow, OH 44224-1032
Phone (330) 945-9300

762 S Cleveland Massillon Rd
Fairlawn, OH 44333-3024
Phone (330) 665-4100

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-8636

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Wooster Clinic, LLC CurrentSince Jun 24, 2020 Accepting new patients
Clinic Medical Services Company Diagnostic Radiology CurrentSince Oct 5, 2020 Accepting new patients
Clinic Medical Services Company LLC Diagnostic Radiology CurrentSince Oct 5, 2020 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Jun 24, 2020 Accepting new patients
Unmc Physicians Past Accepting new patients

Locations

1 Akron General Ave
Akron, OH 44307
Phone (330) 344-5760

2420 Lake Ave
Ashtabula, OH 44004
Phone (216) 986-2919

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

6100 W Creek Rd
Ste 35
Independence, OH 44131
Phone (212) 986-1666

1740 Cleveland Rd
Wooster, OH 44691
Phone (330) 287-4500

Organizations & group practices 5

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 5

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": "1313107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1477832079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AKRON GENERAL AVE",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443072432",
            "telephone_number": "330-344-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 Mercy Dr NW",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "OH",
            "postal_code": "44708",
            "country_code": "US",
            "telephone_number": "330-489-1070",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "981045 Nebraska Medical Ctr",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681981045",
            "country_code": "US",
            "telephone_number": "402-559-1018",
            "fax_number": "402-559-1011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAVANAGH",
        "first_name": "KRISTIN",
        "middle_name": "ERIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-12",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OH",
            "license": "35.131057",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "OH",
            "license": "35.131057",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.131057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "35.131057",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "2013028506",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.