Kristine Miller Kirtley, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA02618 Issued in TX

Practice address

19701 Kingwood Dr.
BLDG 10, St C
Kingwood, TX 77339

Phone

(281) 547-4050

Fax

(832) 644-1475

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristine.kirtley.1@19704.direct.athenahealth.com

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.

• David P Ellent PLLC

  • Pulmonary Disease Physician
  • Spring, TX
  • NPI 1245777440
  Medicare reassignment NPD
• David P Ellent PLLC

  dba Genesis Medical Group

  • Clinical Medical Laboratory
  • Kingwood, TX
  • NPI 1891348959
  NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1750493763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19701 KINGWOOD DR.",
            "address_2": "BLDG 10, ST C",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "77339",
            "telephone_number": "281-547-4050",
            "fax_number": "832-644-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19701 KINGWOOD DR.",
            "address_2": "BLDG 10, ST C",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "77339",
            "telephone_number": "281-547-4050",
            "fax_number": "832-644-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRTLEY",
        "first_name": "KRISTINE",
        "middle_name": "MILLER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA02618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kingwood Psychotherapy & Assessment Center
• Kingwood Smiles Dentistry,PC (Lake Houston Smiles Dentistry)
• Kingwood SNF, LLC
• Kingwood Speech Pathology Services, PLLC
• Kingwood Spine Center Inc.
• Karlee Kleibrink, LPC
• Amber Kloosterman, AS
• Charmagne Kneip, R.PH.
• Rob D Knepper, MS, ATC, LAT, PES, C
• Angela Kay Knight, NNP-BC

• Medical Physician Assistant in Kingwood, TX
• Providers in Kingwood, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.