Individual provider Active NPI

Kristal Elliston Prather, M.D.

  • Pediatrics Physician
  • Baltimore, MD
National Provider Identifier
1679816474
Registry record updated Jun 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D81391 Issued in MD
Practice address
The Johns Hopkins Hospital
1800 Orleans Street
Baltimore, MD 21287-0001
Phone
(410) 955-2727
NPI assigned
Mar 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D81391 MD Primary

Addresses

Primary practice location

The Johns Hopkins Hospital
1800 Orleans Street
Baltimore, MD 21287-0001

Mailing address

1101 Saint Paul St
Apt. 1612
Baltimore, MD 21202-2619
Phone (407) 580-0782

Other names 1

  • Kristal Elliston 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130808000388 MD Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 1557503232

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D81391MDMDPediatrics Physician

Interoperability endpoints

  • Direct secure messaging: kprather20886@gbmcdirect.org

NPI Registry JSON

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

{
    "created_epoch": "1364515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466812800000",
    "number": "1679816474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SAINT PAUL ST",
            "address_2": "APT. 1612",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022619",
            "telephone_number": "407-580-0782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THE JOHNS HOPKINS HOSPITAL",
            "address_2": "1800 ORLEANS STREET",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870001",
            "telephone_number": "410-955-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATHER",
        "first_name": "KRISTAL",
        "middle_name": "ELLISTON",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-29",
        "last_updated": "2016-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D81391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTAL",
            "last_name": "ELLISTON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.