Kristin M Damiano, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

SP023638 Issued in PA

Practice address

1020 Baltimore Pike Ste 100
Glen Mills, PA 19342-1365

Phone

(484) 227-7790

Fax

(484) 227-7791

NPI assigned

Sep 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdamiano@pennderm.emadirect.md

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.

• Main Line Healthcare

  • Family Medicine Physician
  • Newtown Square, PA
  • NPI 1922077643
  Medicare reassignment NPD
• Pennsylvania Dermatology Partners Inc

  • Dermatology Physician
  • West Lawn, PA
  • NPI 1023382918
  Medicare reassignment NPD

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1902574353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 BALTIMORE PIKE STE 100",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421365",
            "telephone_number": "484-227-7790",
            "fax_number": "484-227-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 BALTIMORE PIKE STE 100",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421365",
            "telephone_number": "484-227-7790",
            "fax_number": "484-227-7791"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15237 Creativity Dr",
            "address_purpose": "LOCATION",
            "city": "Culpeper",
            "state": "VA",
            "postal_code": "227012504",
            "country_code": "US",
            "telephone_number": "540-321-4281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMIANO",
        "first_name": "KRISTIN",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-01",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024182600",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "VA",
            "license": "0024182600",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP023638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW EMPLOYER INFO",
            "identifier": "2022656068",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yamara Sheree Coutinho-Sledge, MD
• Jennifer Cross
• Kristin Crothers
• Barbara Csutak
• Catherine Dacosta
• Precious Daniels, PMHCNS-BC
• David a Thomas, LTD (Center for Neuroscience)
• David a Thomas, LTD
• Carie Janelle Davis, M.S. CCC-SLP
• John De Wolf

• Family Nurse Practitioner in Glen Mills, PA
• Providers in Glen Mills, PA by specialty
• Family Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.