NPIMap

Individual provider Active NPI

Kristen Walters Hodges, P.A.-C

  • Surgical Physician Assistant
  • Norman, OK
National Provider Identifier
1609046416
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA1682 Issued in OK
Practice address
3400 W Tecumseh Rd Ste 101
Norman, OK 73072
Phone
(405) 360-6764
Fax
(405) 360-6769
NPI assigned
Mar 7, 2008
Last updated
Feb 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1682 OK
Surgical Physician Assistant 363AS0400X PA1682 OK Primary

Addresses

Primary practice location

3400 W Tecumseh Rd Ste 101
Norman, OK 73072

Mailing address

1800 Renaissance Blvd
Suite 210
Edmond, OK 73013-3023
Phone (405) 509-7370

Other practice location 1

1800 Renaissance Blvd
Suite 210
Edmond, OK 73013-3023
Phone (405) 509-7370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080604000109 OK Practitioner - Physician Assistant 6901976877 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

1000 N Lee Ave
Oklahoma City, OK 73102-1036
Phone (405) 272-7000

1110 N Lee Ave
Oklahoma City, OK 73103-2612

13401 N Western Ave
Suite 302
Oklahoma City, OK 73114-1411
Phone (405) 272-6685

608 NW 9TH St
Oklahoma City, OK 73102-1049

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.96 of 100Reported as group
Quality
80.43
Promoting interoperability
100
Improvement activities
40
Cost
72.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1682OKMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saints Medical Group, LLC CurrentSince Jan 1, 2020 Accepting new patients
Eagle Community Clinic LLC Past Accepting new patients
Edmond Spine and Orthopedics Services LLC Past Accepting new patients
Summit Medical Center Past Accepting new patients
SSM Health Care of Oklahoma, Inc. Past Accepting new patients
The Physicians Group LLC Physician Assistant Past Accepting new patients

Locations

201 S Sara Rd
Ste 200
Mustang, OK 73064
Phone (405) 578-3250

1110 N Lee Ave
Ste 200
Oklahoma City, OK 73103
Phone (405) 218-2530

1111 N Dewey Ave
Oklahoma City, OK 73103
Phone (405) 272-7900

13401 N Western Ave
Ste 301
Oklahoma City, OK 73114
Phone (405) 218-2530

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

777 NW 63rd St
Fl 4
Oklahoma City, OK 73116
Phone (405) 231-3818

Interoperability endpoints

  • Direct secure messaging: khodges49097@direct-ehr-ssmhc.com

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1204848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1609046416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 RENAISSANCE BLVD",
            "address_2": "SUITE 210",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133023",
            "telephone_number": "405-509-7370",
            "fax_number": "405-509-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W TECUMSEH RD STE 101",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "73072",
            "telephone_number": "405-360-6764",
            "fax_number": "405-360-6769"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Renaissance Blvd",
            "address_2": "Suite 210",
            "address_purpose": "LOCATION",
            "city": "Edmond",
            "state": "OK",
            "postal_code": "730133023",
            "country_code": "US",
            "telephone_number": "405-509-7370",
            "fax_number": "405-509-7373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HODGES",
        "first_name": "KRISTEN",
        "middle_name": "WALTERS",
        "name_prefix": "Mrs.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-07",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OK",
            "license": "PA1682",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OK",
            "license": "PA1682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.