Active NPI
Kristen Poole, PA
- Physician Assistant
- Hickory, NC
National Provider Identifier
1568732600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-03310
- Practice address
- 420 N Center St
Hickory, NC 28601-5033 - Phone
- (828) 315-5000
- NPI assigned
- Jan 6, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-03310 | NC | Primary |
Addresses
Primary practice location
420 N Center St
Hickory, NC 28601-5033
Mailing address
PO Box 643822
Cincinnati, OH 45264-3822
Phone (800) 599-0207
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54042 | CA | MD | Pediatric Dentist |
| 0010-03310 | NC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332288000000",
"number": "1568732600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 643822",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452643822",
"telephone_number": "800-599-0207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 N CENTER ST",
"city": "HICKORY",
"state": "NC",
"postal_code": "286015033",
"telephone_number": "828-315-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POOLE",
"first_name": "KRISTEN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-06",
"last_updated": "2012-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-03310",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hickory, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.