Individual provider Active NPI

Kitrina N Van Dine

  • Family Nurse Practitioner
  • Cambridge, OH
National Provider Identifier
1770249948
Registry record updated Nov 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.0029441 Issued in OH
Practice address
1341 Clark St
Cambridge, OH 43725-9614
Phone
(740) 439-8000
NPI assigned
Nov 12, 2021
Last updated
Nov 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0029441 OH Primary

Addresses

Primary practice location

1341 Clark St
Cambridge, OH 43725-9614

Mailing address

PO Box 390
Huntington, WV 25708-0390

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20211122001257 OH Practitioner - Nurse Practitioner 0840689345 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio Valley Physicians IncGroup PAC ID 8729032966, 130 clinicians

Practice addresses (Care Compare)

1341 Clark St
Cambridge, OH 43725-9614
Phone (740) 439-8900

181 Taylor Ave
Columbus, OH 43203-1779
Phone (614) 257-2358

272 Hospital Rd
Chillicothe, OH 45601-9031
Phone (740) 779-7500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN.CNP.0029441OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio Valley Physicians Inc CurrentSince Dec 1, 2021 Accepting new patients
Hospitalist Medicine Physicians of Ohio-Columbus II Professional Corp CurrentSince Jun 1, 2025 Accepting new patients
Ohio Valley Physicians Inc Family CurrentSince Dec 1, 2021 Accepting new patients
Southeastern Ohio Regional Medical Center Inc Past Accepting new patients

Locations

1341 Clark St
Cambridge, OH 43725
Phone (614) 439-8900

1341 Clark St
Ste 1
Cambridge, OH 43725

181 Taylor Ave
Columbus, OH 43203
Phone (614) 257-2358

936 State Route 160
Gallipolis, OH 45631
Phone (740) 446-4600

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636675200000",
    "number": "1770249948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 390",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257080390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 CLARK ST",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437259614",
            "telephone_number": "740-439-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DINE",
        "first_name": "KITRINA",
        "middle_name": "N",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-12",
        "last_updated": "2021-11-12",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0029441",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, OH

Sources for this page

Verify at the official NPI Registry.