Basic Information
| Provider Information | |||||||||
| NPI: | 1487053567 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILL | ||||||||
| FirstName: | KRISTEN | ||||||||
| MiddleName: | |||||||||
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| Credential: | DPT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PIFER | ||||||||
| OtherFirstName: | KRISTIN | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | DPT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 7310 RITCHIE HWY | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | GLEN BURNIE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210613065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4107664047 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 850 S VALLEY FORGE RD UNIT A | ||||||||
| Address2: | |||||||||
| City: | LANSDALE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194464261 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2676497658 | ||||||||
| FaxNumber: | 2672632997 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2014 | ||||||||
| LastUpdateDate: | 08/25/2022 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 08/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 25150 | MD | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | 225100000X | PT030100 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 286923 | 01 | MD | JOHNS HOPKINS | OTHER | 374295ZAVL | 01 | MD | MEDICARE PTAN | OTHER | 0849758 00 | 05 | MD | MEDICAID | 8318150 | 01 | MD | CIGNA | OTHER | T2080095 | 01 | MD | CAREFIRST | OTHER |