Individual provider Active NPI

Kristin Baker Spitznagel, PA-C

  • Physician Assistant
  • Liberty TWP, OH
National Provider Identifier
1952685075
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003438 Issued in OH
Practice address
6645 Princeton Glendale Rd
Liberty TWP, OH 45011-7547
Phone
(513) 829-2883
Fax
(513) 829-6346
NPI assigned
Oct 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.003438 OH Primary

Addresses

Primary practice location

6645 Princeton Glendale Rd
Liberty TWP, OH 45011-7547

Mailing address

2830 Victory Parkway
Payor Enrollment
Cincinnati, OH 45206-1785
Phone (513) 585-5507

Other identifiers 1

IdentifierTypeStateIssuer
0067800MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20111203000007 OH Practitioner - Physician Assistant 0941475917 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Cincinnati Physicians Company LLCGroup PAC ID 2264344480, 1,474 clinicians

Practice addresses (Care Compare)

3188 Bellevue Ave
Cincinnati, OH 45219-2369
Phone (513) 584-1000

Hospital & facility affiliations

  • University of Cincinnati Medical Center, LLC Hospital, Cincinnati, OH, CCN 360003
  • West Chester Hospital Hospital, West Chester, OH, CCN 360354

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Cincinnati Physicians Company, LLC Physician Assistant CurrentSince Feb 1, 2013 Accepting new patients
Premier Health Specialists Inc CurrentSince Oct 11, 2011 Accepting new patients
Premier Health Specialists Inc CurrentSince Oct 11, 2011 Accepting new patients
Modern Psychiatry & Wellness, LLC PastSince Nov 1, 2020 Accepting new patients

Locations

2123 Auburn Ave
#A28
Cincinnati, OH 45219
Phone (513) 585-0523

2830 Victory Pkwy
Cincinnati, OH 45206
Phone (513) 245-3335

3188 Bellevue Ave
Cincinnati, OH 45219
Phone (513) 558-5281

6645 Princeton Glendale Rd
Liberty Twp, OH 45011
Phone (513) 584-8865

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5507/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kspitznagel53148@direct.uchealth.com

Organizations & group practices 6

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": "1317945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1952685075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2830 VICTORY PARKWAY",
            "address_2": "PAYOR ENROLLMENT",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452061785",
            "telephone_number": "513-585-5507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6645 PRINCETON GLENDALE RD",
            "city": "LIBERTY TWP",
            "state": "OH",
            "postal_code": "450117547",
            "telephone_number": "513-829-2883",
            "fax_number": "513-829-6346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPITZNAGEL",
        "first_name": "KRISTIN",
        "middle_name": "BAKER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-07",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0067800",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty TWP, OH

Sources for this page

Verify at the official NPI Registry.