Active NPI
Kristina Kania Bates, PHD
- Clinical Child & Adolescent Psychologist
- Greenville, SC
National Provider Identifier
1629490701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Child & Adolescent Psychologist
- License
- 1407
- Practice address
- 200 Patewood Dr Ste A200
Greenville, SC 29615-3580 - Phone
- (864) 454-5115
- Fax
- (864) 454-5111
- NPI assigned
- Jan 9, 2014
- Last updated
- May 27, 2021
- 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 |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | 1407 | SC | Primary |
Addresses
Primary practice location
200 Patewood Dr Ste A200
Greenville, SC 29615-3580
Mailing address
300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8603
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PS0611 | Medicaid | SC |
Other names 1
- Kristina M Kania
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kkania4937@direct.ghs.myhfn.org | Direct |
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1407 | SC | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622073600000",
"number": "1629490701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E MCBEE AVE FL 4",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012842",
"telephone_number": "864-522-8603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 PATEWOOD DR STE A200",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296153580",
"telephone_number": "864-454-5115",
"fax_number": "864-454-5111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BATES",
"first_name": "KRISTINA",
"middle_name": "KANIA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-09",
"last_updated": "2021-05-27",
"certification_date": "2021-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "SC",
"license": "1407",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PS0611",
"state": "SC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kkania4937@direct.ghs.myhfn.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "kkania4937@direct.ghs.myhfn.org",
"address_1": "200 Patewood Dr Ste A200",
"city": "Greenville",
"state": "SC",
"country_code": "US",
"postal_code": "296153580",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "KRISTINA",
"last_name": "KANIA",
"middle_name": "M",
"credential": "PHD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.