Individual provider Active NPI

Kristine Harris, N.P.

  • Adult Health Clinical Nurse Specialist
  • North Andover, MA
National Provider Identifier
1629476189
Registry record updated Dec 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Clinical Nurse SpecialistTaxonomy code 364SA2200X
License
RN211982 Issued in MA
Practice address
120 Water St
Suite 404
North Andover, MA 01845-2648
Phone
(978) 685-2460
Fax
(978) 685-2572
NPI assigned
Dec 16, 2014
Last updated
Dec 16, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Clinical Nurse Specialist 364SA2200X RN211982 MA Primary
Registered Nurse 163W00000X 211982 MA

Addresses

Primary practice location

120 Water St
Suite 404
North Andover, MA 01845-2648

Mailing address

120 Water St
Suite 404
North Andover, MA 01845-2648
Phone (978) 685-2460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20060208000407 MA Practitioner - Nurse Practitioner 5395750640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pathways Healthcare LLCGroup PAC ID 8729215744, 5 clinicians

Practice addresses (Care Compare)

101 Station Dr
Suite 240
Westwood, MA 02090-2336
Phone (617) 481-9077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
211982MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Healthcare, LLC CurrentSince Feb 14, 2015 Accepting new patients
Cambridge Public Health Commission Past Accepting new patients

Locations

101 Station Dr
Ste 240
Westwood, MA 02090
Phone (781) 706-1079

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1629476189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 WATER ST",
            "address_2": "SUITE 404",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018452648",
            "telephone_number": "978-685-2460",
            "fax_number": "978-685-2572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 WATER ST",
            "address_2": "SUITE 404",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018452648",
            "telephone_number": "978-685-2460",
            "fax_number": "978-685-2572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "KRISTINE",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-16",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SA2200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Adult Health",
            "state": "MA",
            "license": "RN211982",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "211982",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

Verify at the official NPI Registry.