Individual provider Active NPI

Kristin Anne Childers, D.O.

  • Internal Medicine Physician
  • Salem, VA
National Provider Identifier
1790943348
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0102202905 Issued in VA
Practice address
1900 Electric Rd
Salem, VA 24153-7474
Phone
(540) 776-4000
NPI assigned
May 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 0102202905 VA Primary

Addresses

Primary practice location

1900 Electric Rd
Salem, VA 24153-7474

Mailing address

1900 Electric Rd
Salem, VA 24153-7474
Phone (540) 776-4000

Other identifiers 1

IdentifierTypeStateIssuer
1790943348MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, HI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20111025000407 VA Practitioner - Internal Medicine 4880867597 Reassigns benefits to 4 organizations
I20170224001815 HI Practitioner - Internal Medicine 4880867597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carilion Medical CenterGroup PAC ID 9830096585, 956 clinicians

Practice addresses (Care Compare)

101 Elm Ave
Roanoke, VA 24013-2222
Phone (540) 224-4380

101 Elm Ave SE
FL 3
Roanoke, VA 24013-2222
Phone (540) 224-6780

1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone (540) 981-7000

2017 Jefferson St SW
Roanoke, VA 24014-2419
Phone (540) 981-7925

2017 S Jefferson St
Roanoke, VA 24014-2419
Phone (540) 981-7128

Hospital & facility affiliations

  • Carilion Medical Center Hospital, Roanoke, VA, CCN 490024
  • Carilion New River Valley Medical Center Hospital, Christiansburg, VA, CCN 490042
  • Carilion Franklin Memorial Hospital Hospital, Rocky Mount, VA, CCN 490089

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102202905VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Healthcare Corporation CurrentSince Aug 21, 2017 Accepting new patients
Carilion Medical Center CurrentSince Aug 21, 2017 Accepting new patients
Carilion Medical Center CurrentSince Aug 21, 2017 Accepting new patients
Carilion Giles Community Hospital CurrentSince Jun 10, 2020 Accepting new patients
Sound Physicians of Hawaii Inc Internal Medicine CurrentSince Feb 1, 2017 Accepting new patients
Carilion Giles Community Hospital CurrentSince Jun 10, 2020 Accepting new patients
Carilion Healthcare Corporation CurrentSince Aug 21, 2017 Accepting new patients
Carilion Rockbridge Community Hospital CurrentSince Jun 10, 2020 Accepting new patients

Locations

79-1019 Haukapila St
Kealakekua, HI 96750
Phone (808) 322-4413

5410 Maryland Way
Ste 300
Brentwood, TN 37027
Phone (615) 377-1674

1 Health Cir
Lexington, VA 24450
Phone (540) 458-3300

159 Hartley Way
Pearisburg, VA 24134
Phone (540) 921-6000

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

213 S Jefferson St
Ste 625
Roanoke, VA 24011
Phone (540) 224-5677

6415 Peters Creek Rd
Roanoke, VA 24019
Phone (703) 562-2110

1900 Electric Rd
Salem, VA 24153
Phone (540) 772-3400

Interoperability endpoints

  • Direct secure messaging: kgeers13043@direct.carilionclinic.org

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331251200000",
    "number": "1790943348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 ELECTRIC RD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537474",
            "telephone_number": "540-776-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 ELECTRIC RD",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537474",
            "telephone_number": "540-776-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "KRISTIN",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-30",
        "last_updated": "2012-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102202905",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790943348",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

Verify at the official NPI Registry.