Individual provider Active NPI

Kristin A Himes, PA-C

  • Physician Assistant
  • Statesville, NC
National Provider Identifier
1548500085
Registry record updated Sep 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-04008 Issued in NC
Practice address
208 Old Mocksville Rd
Statesville, NC 28625-1953
Phone
(704) 838-8240
Fax
(704) 924-5360
NPI assigned
Feb 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-04008 NC Primary

Addresses

Primary practice location

208 Old Mocksville Rd
Statesville, NC 28625-1953

Mailing address

PO Box 1845
Statesville, NC 28687-1845
Phone (704) 838-8240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130607000669 NC Practitioner - Physician Assistant 9234377995 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catawba Valley Medical Group IncGroup PAC ID 6305007279, 133 clinicians

Practice addresses (Care Compare)

2386 Springs Rd NE
Hickory, NC 28601-3066
Phone (828) 732-5400

3900 Terrell Park Dr
Sherrills Ford, NC 28673-9510

50 Macedonia Church Rd a
Taylorsville, NC 28681-8414
Phone (828) 732-5300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-04008NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Valley Medical Group Inc CurrentSince Feb 10, 2020 Accepting new patients
Catawba Valley Medical Group Inc CurrentSince Feb 10, 2020 Accepting new patients

Locations

200 Rosenwald School St
Catawba, NC 28609
Phone (828) 241-2377

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

2386 Springs Rd NE
Hickory, NC 28601
Phone (828) 256-2112

3900 Terrell Park Dr
Ste 100
Sherrills Frd, NC 28673
Phone (828) 732-5450

50 Macedonia Church Rd
#A
Taylorsville, NC 28681
Phone (828) 732-5300

Interoperability endpoints

  • Direct secure messaging: kristin.himes@cvmg.eclinicaldirectplus.com

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1361318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1548500085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-838-8240",
            "fax_number": "704-924-5360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 OLD MOCKSVILLE RD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251953",
            "telephone_number": "704-838-8240",
            "fax_number": "704-924-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIMES",
        "first_name": "KRISTIN",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-20",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.