Active NPI
Kristin D Dehaven, MD
- Obstetrics & Gynecology Physician
- Winchester, VA
National Provider Identifier
1497868459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 0101235422
- Practice address
- 1830 Plaza Dr
Winchester, VA 22601-6365 - Phone
- (540) 665-8414
- Fax
- (540) 667-2476
- NPI assigned
- Aug 16, 2006
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 0101235422 | VA | Primary |
Addresses
Primary practice location
1830 Plaza Dr
Winchester, VA 22601-6365
Mailing address
1830 Plaza Dr
Winchester, VA 22601-6365
Phone (540) 665-8414
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010042224 | Medicaid | VA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 1, 2017 through Jul 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101235422 | VA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Interoperability endpoints
- womenscenterofwinchester.kristindehaven@126082.advancedmd-direct.com
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632355200000",
"number": "1497868459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1830 PLAZA DR",
"city": "WINCHESTER",
"state": "VA",
"postal_code": "226016365",
"telephone_number": "540-665-8414",
"fax_number": "540-667-2476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1830 PLAZA DR",
"city": "WINCHESTER",
"state": "VA",
"postal_code": "226016365",
"telephone_number": "540-665-8414",
"fax_number": "540-667-2476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEHAVEN",
"first_name": "KRISTIN",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-16",
"last_updated": "2021-09-23",
"certification_date": "2021-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "VA",
"license": "0101235422",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010042224",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winchester, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.