Individual provider Active NPI

Kristin Lynn Eckland, ACNP, BC, RNFA

  • Acute Care Nurse Practitioner
  • Roanoke, VA
National Provider Identifier
1508841370
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
0024167225 Issued in VA
Practice address
2001 Crystal Spring Ave SW Ste 201
Roanoke, VA 24014-2465
Phone
(540) 853-0100
NPI assigned
Dec 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 61944 WV
Acute Care Nurse Practitioner 363LA2100X PENDING VI
Acute Care Nurse Practitioner 363LA2100X AP4242 AZ
Acute Care Nurse Practitioner 363LA2100X 0024167225 VA Primary
Acute Care Nurse Practitioner 363LA2100X 2005-01389 NC
Acute Care Nurse Practitioner 363LA2100X APN0000011834 TN

Addresses

Primary practice location

2001 Crystal Spring Ave SW Ste 201
Roanoke, VA 24014-2465

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other identifiers 5

IdentifierTypeStateIssuer
11834OtherTNADVANCED PRACTICE NURSE
2005009361-28OtherNATIONAL CERTIFICATION
PENDINGOtherVINURSING LICENSE
61944OtherWVNURSING LICENSE/ ADVANCED
140397OtherTNRN LICENSE (NP PENDING)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, DC2 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
I20200622002490 CA Practitioner - Nurse Practitioner 6002825890 Reassigns benefits to 5 organizations
I20241016001839 DC Practitioner - Nurse Practitioner 6002825890 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11834TNMDPhysical Therapist
AP4242AZMDAcute Care Nurse Practitioner
2005-01389NCMDAcute Care Nurse Practitioner
APN0000011834TNMDAcute Care Nurse Practitioner
0024167225VAMDAcute Care Nurse Practitioner
PENDINGVIMDAcute Care Nurse Practitioner
61944WVMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Pediatrics Associates CurrentSince Jun 11, 2020 Accepting new patients
UCSF Medical Group Business Services Acute Care CurrentSince Jun 11, 2020 Accepting new patients
Inova Health Care Services CurrentSince Sep 23, 2024 Accepting new patients
University of California San Francisco CurrentSince Jun 11, 2020 Accepting new patients
University of California San Francisco CurrentSince Jun 11, 2020 Accepting new patients
Inova Health Care Services CurrentSince Sep 23, 2024 Accepting new patients
University of California San Francisco Current Accepting new patients
Regents of the University of California CurrentSince Jun 11, 2020 Accepting new patients
UCSF Dept of Surgery CurrentSince Jun 11, 2020 Accepting new patients
UCSF Medical Group Business Services CurrentSince Jun 11, 2020 Accepting new patients

Locations

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

Interoperability endpoints

  • Direct secure messaging: keckland655398@hisp.ehr.sutterhealth.org

Organizations & group practices 10

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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1508841370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 CRYSTAL SPRING AVE SW STE 201",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240142465",
            "telephone_number": "540-853-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKLAND",
        "first_name": "KRISTIN",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "ACNP, BC, RNFA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WV",
            "license": "61944",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VI",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP4242",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "VA",
            "license": "0024167225",
            "primary": true
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NC",
            "license": "2005-01389",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "APN0000011834",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE NURSE",
            "identifier": "11834",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL CERTIFICATION",
            "identifier": "2005009361-28",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE",
            "identifier": "PENDING",
            "state": "VI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSING LICENSE/ ADVANCED",
            "identifier": "61944",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE (NP PENDING)",
            "identifier": "140397",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.