Individual provider Active NPI

Kristen Zima, PHYSICIAN ASSISTANT

  • Medical Physician Assistant
  • Shallotte, NC
National Provider Identifier
1992581458
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
4612 Main St
Shallotte, NC 28470-4452
Phone
(910) 444-2970
NPI assigned
Aug 31, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

4612 Main St
Shallotte, NC 28470-4452

Mailing address

3729 Friendly Orange CT NE
Leland, NC 28451-9801
Phone (330) 241-8252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, PA2 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
I20231121002424 NC Practitioner - Physician Assistant 5395193965 Reassigns benefits to 1 organization
I20241004003446 PA Practitioner - Physician Assistant 5395193965 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Gastroenterology Associates of Lancaster, LTD.Group PAC ID 4688575434, 248 clinicians

Practice addresses (Care Compare)

2112 Harrisburg Pike
Suite 202
Lancaster, PA 17601-2644
Phone (717) 869-4600

80 Landings Dr
Suite 205
Washington, PA 15301-9408
Phone (724) 941-3020

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Midatlantic Endoscopy LLC Current Accepting new patients
Regional Gastroenterology Associates of Lancaster, LTD. CurrentSince Sep 1, 2024 Accepting new patients

Locations

2112 Harrisburg Pike
Ste 202
Lancaster, PA 17601
Phone (717) 544-3500

Organizations & group practices 5

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 1

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": "1693440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1992581458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3729 FRIENDLY ORANGE CT NE",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284519801",
            "telephone_number": "330-241-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4612 MAIN ST",
            "city": "SHALLOTTE",
            "state": "NC",
            "postal_code": "284704452",
            "telephone_number": "910-444-2970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIMA",
        "first_name": "KRISTEN",
        "name_prefix": "Miss",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shallotte, NC

Sources for this page

Verify at the official NPI Registry.