Individual provider Active NPI

Kristen Vestigo, PA-C

  • Physician Assistant
  • Statesville, NC
National Provider Identifier
1992296248
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-09401 Issued in NC
Practice address
252 Turnersburg Hwy Ste E
Statesville, NC 28625-2755
Phone
(610) 595-6540
NPI assigned
May 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

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 0010-09401 NC Primary

Addresses

Primary practice location

252 Turnersburg Hwy Ste E
Statesville, NC 28625-2755

Mailing address

508 Division St
Cinnaminson, NJ 08077-2148
Phone (484) 366-7519

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20230320002645 SC Practitioner - Physician Assistant 8325472897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beaufort County Memorial HospitalGroup PAC ID 7810809365, 197 clinicians

Practice addresses (Care Compare)

122 Okatie Ctr Blvd N
Suite 100
Okatie, SC 29909-3750
Phone (843) 524-3344

1680 Ribaut Rd
Port Royal, SC 29935-2008
Phone (843) 524-3344

Hospital & facility affiliations

  • Pruitthealth Home Health-Low Country Home health agency, Bluffton, SC, CCN 427123
  • Beaufort County Memorial Hospital Hospital, Beaufort, SC, CCN 420067

Merit-based Incentive Payment System (MIPS)

Final score
86.95 of 100Reported as group
Quality
83.15
Promoting interoperability
100
Improvement activities
40
Cost
73.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-09401NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Beaufort County Memorial Hospital CurrentSince Nov 4, 2022 Accepting new patients
Beaufort County Memorial Hospital CurrentSince Nov 4, 2022 Accepting new patients

Locations

122 Okatie Center Blvd N
Ste 100
Okatie, SC 29909
Phone (843) 706-2185

1680 Ribaut Rd
Port Royal, SC 29935
Phone (843) 522-7600

Interoperability endpoints

  • Direct secure messaging: kristen.vestigo.1@16436.direct.athenahealth.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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1992296248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 DIVISION ST",
            "city": "CINNAMINSON",
            "state": "NJ",
            "postal_code": "080772148",
            "telephone_number": "484-366-7519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 TURNERSBURG HWY STE E",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286252755",
            "telephone_number": "610-595-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESTIGO",
        "first_name": "KRISTEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-09401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.