Individual provider Active NPI

Kristina E Van Belle, M.D.

  • Pediatrics Physician
  • Batesville, IN
National Provider Identifier
1891130001
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A136100 Issued in CA
Practice address
321 Mitchell Ave
Batesville, IN 47006-8909
Phone
(812) 933-5018
Fax
(812) 933-5472
NPI assigned
May 1, 2013
Last updated
Oct 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01077639A IN
Pediatrics Physician 208000000X A136100 CA Primary

Addresses

Primary practice location

321 Mitchell Ave
Batesville, IN 47006-8909

Mailing address

PO Box 236
Batesville, IN 47006-0236
Phone (812) 933-5441

Other names 1

  • Kristina E Wang Professional name

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231212003790 CA Practitioner - Pediatric Medicine 9234410705 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A136100CAMDPediatrics Physician
01077639AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Oct 15, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Oct 15, 2023 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

393 E Walnut St
Fl 5
Pasadena, CA 91188
Phone (310) 403-3235

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

Interoperability endpoints

  • Direct secure messaging: kristina.wang@mmhealth.cernerdirect.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1891130001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 236",
            "city": "BATESVILLE",
            "state": "IN",
            "postal_code": "470060236",
            "telephone_number": "812-933-5441",
            "fax_number": "812-933-5446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 MITCHELL AVE",
            "city": "BATESVILLE",
            "state": "IN",
            "postal_code": "470068909",
            "telephone_number": "812-933-5018",
            "fax_number": "812-933-5472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN BELLE",
        "first_name": "KRISTINA",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-01",
        "last_updated": "2023-10-27",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01077639A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A136100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "WANG",
            "middle_name": "E",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Batesville, IN

Sources for this page

Verify at the official NPI Registry.