Individual provider Active NPI

Kristen R McGaha, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bel Air, MD
National Provider Identifier
1477898591
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
R130712 Issued in MD
Practice address
103 N Main St
Bel Air, MD 21014-3539
Phone
(888) 333-1345
NPI assigned
Nov 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R130712 MD Primary

Addresses

Primary practice location

103 N Main St
Bel Air, MD 21014-3539

Mailing address

103 N Main St
Bel Air, MD 21014-3539

Other practice location 1

2827 Smith Ave
Baltimore, MD 21209-1426
Phone (410) 483-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130118000107 NC Practitioner - Nurse Practitioner 4082867387 Reassigns benefits to 1 organization
I20180820003439 MD Practitioner - Nurse Practitioner 4082867387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Wellness HealthcareGroup PAC ID 1052688389, 9 clinicians

Practice addresses (Care Compare)

2209 Commerce Rd
Suite 1
Forest Hill, MD 21050-2539
Phone (888) 333-1345

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R130712MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Spine, Pain and Rehabilitation PLLC CurrentSince Dec 28, 2012 Accepting new patients
Premier Wellness Healthcare CurrentSince Mar 20, 2025 Accepting new patients
Small Point Urgent Care, P.C. CurrentSince Jan 1, 2024 Accepting new patients
Premier Wellness Healthcare CurrentSince Aug 1, 2024 Accepting new patients
Ez Primed LLC Past Accepting new patients
Premier Wellness Healthcare Past Accepting new patients

Locations

2827 Smith Ave
Baltimore, MD 21209
Phone (410) 419-9984

103 N Main St
#A
Bel Air, MD 21014
Phone (888) 333-1345

103 N Main St
Bel Air, MD 21014
Phone (888) 333-1345

2209 Commerce Rd
Ste 1
Forest Hill, MD 21050

2219 York Rd
Ste 102
Timonium, MD 21093
Phone (410) 453-0002

900 Cox Rd
Ste A
Gastonia, NC 28054
Phone (704) 864-3300

Organizations & group practices 6

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": "1354147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1477898591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 N MAIN ST",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210143539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N MAIN ST",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210143539",
            "telephone_number": "888-333-1345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2827 Smith Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212091426",
            "country_code": "US",
            "telephone_number": "410-483-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGAHA",
        "first_name": "KRISTEN",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-29",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R130712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

Verify at the official NPI Registry.