NPIMap

Individual provider Active NPI

Kristina Renae Hawkins, DO

  • Family Medicine Physician
  • Montgomery, WV
National Provider Identifier
1619085735
Registry record updated Feb 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2146 Issued in WV
Practice address
401 6TH Ave
Montgomery, WV 25136-2116
Phone
(304) 442-2521
Fax
(304) 442-7463
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2146 WV Primary

Addresses

Primary practice location

401 6TH Ave
Montgomery, WV 25136-2116

Mailing address

401 6TH Ave
Montgomery, WV 25136-2116
Phone (304) 442-2521

Other identifiers 1

IdentifierTypeStateIssuer
3810003697MedicaidWV

Other names 1

  • Mrs. Kristina Renae Marcum Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20051014000763 WV Practitioner - Family Practice 1658397088 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montgomery General Hospital, IncGroup PAC ID 6204735269, 37 clinicians

Practice addresses (Care Compare)

401 6TH Ave
Montgomery, WV 25136-2116
Phone (304) 442-5151

Hospital & facility affiliations

  • Adoration Home Health Home health agency, Charleston, WV, CCN 517115
  • Centerwell Home Health Home health agency, South Charleston, WV, CCN 517048
  • Montgomery General Hospital Hospital, Montgomery, WV, CCN 511318
  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022
  • Thomas Memorial Hospital Hospital, South Charleston, WV, CCN 510029
  • Montgomery General Hospital Nursing home, Montgomery, WV, CCN 515081

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2146WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery General Hospital, Inc CurrentSince Feb 1, 2010 Accepting new patients
Montgomery General Hospital, Inc Family Medicine CurrentSince Feb 1, 2010 Accepting new patients
Montgomery General Hospital, Inc. Past Accepting new patients
New River Health Association, Inc. Past Accepting new patients

Locations

401 6th Ave
Montgomery, WV 25136
Phone (304) 442-5151

Organizations & group practices 6

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 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362009600000",
    "number": "1619085735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 6TH AVE",
            "city": "MONTGOMERY",
            "state": "WV",
            "postal_code": "251362116",
            "telephone_number": "304-442-2521",
            "fax_number": "304-442-7463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 6TH AVE",
            "city": "MONTGOMERY",
            "state": "WV",
            "postal_code": "251362116",
            "telephone_number": "304-442-2521",
            "fax_number": "304-442-7463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINS",
        "first_name": "KRISTINA",
        "middle_name": "RENAE",
        "name_prefix": "Ms.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2013-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "2146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810003697",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "MARCUM",
            "middle_name": "RENAE",
            "prefix": "MRS.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Montgomery, WV

Sources for this page

Verify at the official NPI Registry.