Individual provider Active NPI

Kristin Hextall

  • Family Nurse Practitioner
  • Cherry Hill, NJ
National Provider Identifier
1790147304
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
26NJ00626300 Issued in NJ
Practice address
1916 Route 70 E Ste 4
Cherry Hill, NJ 08003-2139
Phone
(856) 230-7684
Fax
(856) 249-9427
NPI assigned
Mar 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN603891 PA
Registered Nurse 163W00000X 26NR17986800 NJ
Family Nurse Practitioner 363LF0000X SP015344 PA
Family Nurse Practitioner 363LF0000X 26NJ00626300 NJ Primary

Addresses

Primary practice location

1916 Route 70 E Ste 4
Cherry Hill, NJ 08003-2139

Mailing address

1916 Route 70 E Ste 4
Cherry Hill, NJ 08003-2139
Phone (856) 230-7684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160505000051 NJ Practitioner - Nurse Practitioner 1850690348 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26NR17986800NJMDRegistered Nurse
RN603891PAMDRegistered Nurse
26NJ00626300NJMDFamily Nurse Practitioner
SP015344PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advocare, LLC CurrentSince Apr 1, 2016 Accepting new patients
Cooper Family Medicine, PC CurrentSince Jan 15, 2024 Accepting new patients
Advocare , LLC CurrentSince Apr 1, 2016 Accepting new patients
Cooper Family Medicine Past Accepting new patients

Locations

1865 Harrison Ave
Ste 1300
Camden, NJ 08105
Phone (856) 963-0126

3156 River Rd
Camden, NJ 08105
Phone (856) 356-4988

504 White Horse Pike
Haddon Hgts, NJ 08035
Phone (856) 546-7990

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

1001 Lincoln Dr W
Ste F
Marlton, NJ 08053
Phone (609) 810-1800

402 Lippincott Dr
Marlton, NJ 08053
Phone (410) 763-8787

2963 Marne Hwy
Mount Laurel, NJ 08054
Phone (856) 638-1990

100 Route 73
Voorhees, NJ 08043
Phone (610) 783-3600

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1790147304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1916 ROUTE 70 E STE 4",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032139",
            "telephone_number": "856-230-7684",
            "fax_number": "856-249-9427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 ROUTE 70 E STE 4",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080032139",
            "telephone_number": "856-230-7684",
            "fax_number": "856-249-9427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEXTALL",
        "first_name": "KRISTIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-23",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN603891",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR17986800",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP015344",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NJ",
            "license": "26NJ00626300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

Verify at the official NPI Registry.