Individual provider Active NPI

Kristin Catherine Rhodes, NP

  • Family Nurse Practitioner
  • Tustin, CA
National Provider Identifier
1629179502
Registry record updated Oct 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
469472 Issued in CA
Practice address
1095 Irvine Blvd
Tustin, CA 92780-3526
Phone
(714) 505-7110
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 469472 CA Primary

Addresses

Primary practice location

1095 Irvine Blvd
Tustin, CA 92780-3526

Mailing address

1095 Irvine Blvd
Tustin, CA 92780-3526
Phone (714) 505-7110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20081219000531 CA Practitioner - Nurse Practitioner 0446312722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Medical FoundationGroup PAC ID 8921993205, 1,461 clinicians

Practice addresses (Care Compare)

100 E Valencia Mesa Dr
Suite 105
Fullerton, CA 92835-3816
Phone (714) 871-3006

1095 Irvine Blvd
Tustin, CA 92780-3526
Phone (714) 505-7110

1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350

2501 E Chapman Ave
Orange, CA 92869-3204
Phone (714) 633-7175

845 W la Veta Ave
Orange, CA 92868-3930

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Sep 24, 2023 Accepting new patients
Providence Medical Foundation CurrentSince Sep 24, 2023 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841

19333 Bear Valley Rd
Ste 106
Apple Valley, CA 92308
Phone (760) 240-5505

1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835

100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200

57 Prism
Irvine, CA 92618
Phone (818) 847-6881

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

1095 Irvine Blvd
Tustin, CA 92780
Phone (714) 505-7110

Interoperability endpoints

  • Direct secure messaging: krhodes1132115@oc.providencedirect.org

Organizations & group practices 5

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 2

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1629179502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1095 IRVINE BLVD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803526",
            "telephone_number": "714-505-7110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1095 IRVINE BLVD",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803526",
            "telephone_number": "714-505-7110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHODES",
        "first_name": "KRISTIN",
        "middle_name": "CATHERINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2023-10-24",
        "certification_date": "2023-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "469472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.