Individual provider Active NPI

Kristin D Smith, NP

  • Nurse Practitioner
  • Durham, NC
National Provider Identifier
1912346875
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5006226 Issued in NC
Practice address
5832 Fayetteville Rd
Suite 113
Durham, NC 27713-6290
Phone
(919) 620-4700
NPI assigned
Jun 24, 2013
Last updated
Jun 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5006226 NC Primary

Addresses

Primary practice location

5832 Fayetteville Rd
Suite 113
Durham, NC 27713-6290

Mailing address

PO Box 751274
Charlotte, NC 28275-1274
Phone (919) 620-4700

Other names 1

  • Kristin D Anderson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130716000729 NC Practitioner - Nurse Practitioner 7719127711 Reassigns benefits to 2 organizations
I20211111000229 FL Practitioner - Nurse Practitioner 7719127711 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5006226NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mindhealthy PC CurrentSince May 7, 2021 Accepting new patients
Duke University Affiliated Physicians, Inc. CurrentSince Jul 8, 2013 Accepting new patients
Duke University Affiliated Physicians, Inc. CurrentSince Jul 8, 2013 Accepting new patients

Locations

115 N Calhoun St
Ste 4
Tallahassee, FL 32301
Phone (323) 776-3632

1901 Hillandale Rd
Ste D
Durham, NC 27705
Phone (919) 383-4355

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

5832 Fayetteville Rd
Ste 113
Durham, NC 27713
Phone (919) 544-2049

1001 Aviation Pkwy
Ste 400
Morrisville, NC 27560
Phone (833) 375-5300

909 Aviation Pkwy
Ste 400
Morrisville, NC 27560
Phone (888) 510-1352

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": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1912346875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751274",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751274",
            "telephone_number": "919-620-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5832 FAYETTEVILLE RD",
            "address_2": "SUITE 113",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136290",
            "telephone_number": "919-620-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRISTIN",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5006226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "ANDERSON",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.