Active NPI
Kristin Andrea De Vries, RN
- Registered Nurse
- Hampstead, MD
National Provider Identifier
1487997367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- R192070
- Practice address
- 4222 Wolf Hill Dr
Hampstead, MD 21074-2009 - Phone
- (443) 744-1913
- Fax
- (443) 291-6680
- NPI assigned
- Mar 29, 2013
- Last updated
- Mar 29, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R192070 | MD | Primary |
Addresses
Primary practice location
4222 Wolf Hill Dr
Hampstead, MD 21074-2009
Mailing address
4222 Wolf Hill Drive
Hampstead, MD 21074
Phone (443) 744-1913
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R192070 | Other | MD | MBON |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R192070 | MD | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364515200000",
"number": "1487997367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4222 WOLF HILL DRIVE",
"city": "HAMPSTEAD",
"state": "MD",
"postal_code": "21074",
"telephone_number": "443-744-1913",
"fax_number": "443-291-6680"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4222 WOLF HILL DR",
"city": "HAMPSTEAD",
"state": "MD",
"postal_code": "210742009",
"telephone_number": "443-744-1913",
"fax_number": "443-291-6680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE VRIES",
"first_name": "KRISTIN",
"middle_name": "ANDREA",
"name_prefix": "Ms.",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-29",
"last_updated": "2013-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MD",
"license": "R192070",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MBON",
"identifier": "R192070",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hampstead, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.