Individual provider Active NPI

Kristine Hickman, CRNP, FNP-C

  • Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1629515812
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R160049 Issued in MD
Practice address
505 E Main St
Salisbury, MD 21804-5020
Phone
(410) 341-3420
NPI assigned
Jan 25, 2017
Last updated
Feb 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R160049 MD Primary
Family Nurse Practitioner 363LF0000X R160049 MD
Psychiatric/Mental Health Nurse Practitioner 363LP0808X R160049 MD

Addresses

Primary practice location

505 E Main St
Salisbury, MD 21804-5020

Mailing address

505 E Main St
Salisbury, MD 21804-5020
Phone (410) 341-3420

Other names 1

  • Kristine Lamont Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20170412001627 MD Practitioner - Nurse Practitioner 3870879588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
HealthportGroup PAC ID 2365469947, 15 clinicians

Practice addresses (Care Compare)

505 E Main St
Salisbury, MD 21804-5020
Phone (410) 341-3420

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R160049MDMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthport Current Accepting new patients
Healthport CurrentSince Feb 1, 2017 Accepting new patients
Healthport CurrentSince Feb 1, 2017 Accepting new patients
Healthport Past Accepting new patients

Locations

208 E Main St
Ste C
Salisbury, MD 21801
Phone (443) 324-9486

431 E Main St
Salisbury, MD 21804
Phone (410) 341-9696

505 E Main St
Salisbury, MD 21804
Phone (410) 341-4710

Organizations & group practices 4

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": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1629515812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E MAIN ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218045020",
            "telephone_number": "410-341-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E MAIN ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218045020",
            "telephone_number": "410-341-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "KRISTINE",
        "credential": "CRNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-25",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R160049",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R160049",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R160049",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "LAMONT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.