Individual provider Active NPI

Kristen A Nork, MD

  • Family Medicine Physician
  • Reno, NV
National Provider Identifier
1730169533
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
12600 Issued in NV
Practice address
580 W 5TH St
Reno, NV 89503-4407
Phone
(775) 786-4673
Fax
(775) 348-2889
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.131675 OH
Family Medicine Physician 207Q00000X 12600 NV Primary

Addresses

Primary practice location

580 W 5TH St
Reno, NV 89503-4407

Mailing address

580 W 5TH St
Reno, NV 89503-4407
Phone (775) 786-4673

Other identifiers 2

IdentifierTypeStateIssuer
11133021OtherCAQH
1730169533MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20080508000113 NV Practitioner - Family Practice 3375433451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nevada School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northern Nevada HIV Outpatient Program Education and ServicesGroup PAC ID 4385635119, shared by 2 NPIs, 38 clinicians

Practice addresses (Care Compare)

580 W 5TH St
Reno, NV 89503-4407
Phone (775) 786-4673

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12600NVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Nevada HIV Outpatient Program, Education and Services CurrentSince Jan 28, 2019 Accepting new patients
Doctors Clinic LLP Family Medicine Current Accepting new patients
Northern Nevada HIV Outpatient Program, Education and Services CurrentSince Jan 28, 2019 Accepting new patients
Miami Valley Hospital Past Accepting new patients
Sparks Family Hospital Inc Past Accepting new patients
Salem Health Family Medicine Past Accepting new patients
Prime Healthcare Services - Reno LLC Past Accepting new patients
Northern Nevada HIV Outpatient Program, Education and Services Past Accepting new patients
Renown Regional Medical Center Past Accepting new patients

Locations

580 W 5th St
Reno, NV 89503
Phone (775) 786-4673

5050 Skyline Village Loop S
Salem, OR 97306
Phone (503) 291-2123

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1730169533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 W 5TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034407",
            "telephone_number": "775-786-4673",
            "fax_number": "775-348-2889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W 5TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034407",
            "telephone_number": "775-786-4673",
            "fax_number": "775-348-2889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORK",
        "first_name": "KRISTEN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.131675",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "12600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11133021",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730169533",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.