Kristen Shaw Deitchman, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

H0081342 Issued in MD

Practice address

4924 Campbell Blvd
Suite 200
Nottingham, MD 21236-5908

Phone

(443) 442-2300

Fax

(410) 367-2035

NPI assigned

Jun 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristen Elizabeth Shaw Former name

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Johns Hopkins Community Physicians, Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1578598868

  DC, Pediatrics

  Medicare reassignment NPD
• Upper Chesapeake Medical Services, Inc

  • Hospitalist Physician
  • Bel Air, MD
  • NPI 1497801419
  Medicare reassignment NPD
• Johns Hopkins Community Physicians

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1356161806
  NPD
• Johns Hopkins Community Physicians, Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1255359972

  Pediatrics

  NPD
• Johns Hopkins Community Physicians, Inc

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1770518003
  NPD
• Gomez Yim & Rastogi, M.D., P.a.

  • Pediatrics Physician
  • Havre de Grace, MD
  • NPI 1154145290
  NPD (past)
• Gomez Yim & Rastogi, M.D., P.a.

  • Pediatrics Physician
  • Bel Air, MD
  • NPI 1407980717
  NPD (past)

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

{
    "created_epoch": "1308614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1477849149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4924 CAMPBELL BLVD",
            "address_2": "SUITE 200",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212365908",
            "telephone_number": "443-442-2300",
            "fax_number": "410-367-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4924 CAMPBELL BLVD",
            "address_2": "SUITE 200",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212365908",
            "telephone_number": "443-442-2300",
            "fax_number": "410-367-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEITCHMAN",
        "first_name": "KRISTEN",
        "middle_name": "SHAW",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-21",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "H0081342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "SHAW",
            "middle_name": "ELIZABETH",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adiel Davis
• Yolanda Ti'Esha Davis, PMHNP-BC, CRNP-PMH
• Vanessa Joy Yabut De Guzman
• Ruby De la Cruz
• Katherine Decker, COMS
• Judith Rubin Dejarnette, MD
• Fernando Alfonso Delgado, MD
• Abigail Demastus
• Theresa L Dematteo Pugh, MS CRNP
• Kinjal Desai

• Pediatrics Physician in Nottingham, MD
• Providers in Nottingham, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.