Individual provider Active NPI

Mary Anne Kiessling-Uritis, M.D.

  • Pediatrics Physician
  • Hendersonville, NC
National Provider Identifier
1912986233
Registry record updated Dec 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
9701794 Issued in NC
Practice address
50 Hospital Dr
Suite 5D
Hendersonville, NC 28792-5248
Phone
(828) 650-8032
Fax
(828) 650-8033
NPI assigned
Jan 13, 2006
Last updated
Dec 6, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 9701794 NC Primary

Addresses

Primary practice location

50 Hospital Dr
Suite 5D
Hendersonville, NC 28792-5248

Mailing address

PO Box 1869
Fletcher, NC 28732-1869
Phone (828) 687-5616

Other identifiers 3

IdentifierTypeStateIssuer
8910947MedicaidNC
N01794OtherSCSC MEDICAID
10947OtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20070829000979 NC Practitioner - Pediatric Medicine 3072606540 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9701794NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fletcher Hospital Inc CurrentSince May 24, 2014 Accepting new patients
Fletcher Hospital Inc. Current Accepting new patients
Fletcher Hospital Inc. CurrentSince May 24, 2014 Accepting new patients

Locations

50 Hospital Dr
Ste 5D
Hendersonville, NC 28792
Phone (828) 650-8032

80 Doctors Dr
Ste 1
Hendersonvlle, NC 28792
Phone (282) 654-0073

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": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480982400000",
    "number": "1912986233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1869",
            "city": "FLETCHER",
            "state": "NC",
            "postal_code": "287321869",
            "telephone_number": "828-687-5616",
            "fax_number": "828-650-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 HOSPITAL DR",
            "address_2": "SUITE 5D",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287925248",
            "telephone_number": "828-650-8032",
            "fax_number": "828-650-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIESSLING-URITIS",
        "first_name": "MARY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-13",
        "last_updated": "2016-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "9701794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8910947",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SC MEDICAID",
            "identifier": "N01794",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "10947",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, NC

Sources for this page

Verify at the official NPI Registry.