Individual provider Active NPI

Kristyn J. Dullaghan, PA-C

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1093339913
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2644 Issued in KY
Practice address
160 N Eagle Creek Dr
Lexington, KY 40509-2121
Phone
(859) 264-9820
Fax
(859) 543-0994
NPI assigned
Jun 5, 2020
Last updated
May 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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 PA2644 KY Primary

Addresses

Primary practice location

160 N Eagle Creek Dr
Lexington, KY 40509-2121

Mailing address

PO Box 936
London, KY 40743-0936
Phone (606) 330-7835

Other practice location 1

216 Fountain Ct, 216
Lexington, KY 40509-2510
Phone (859) 276-5008

Other identifiers 1

IdentifierTypeStateIssuer
7100681320MedicaidKY

Other names 1

  • Kristyn J. Bossle Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20200821002740 KY Practitioner - Physician Assistant 9931525896 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ortho Kentucky PLLCGroup PAC ID 1951432665, 13 clinicians

Practice addresses (Care Compare)

160 N Eagle Creek Dr
Suite 101
Lexington, KY 40509-2121
Phone (859) 967-5613

216 Fountain CT
Suite 250
Lexington, KY 40509-2510
Phone (859) 276-5008

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2644KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Physician Assistant CurrentSince Aug 1, 2020 Accepting new patients
Ortho Kentucky PLLC Physician Assistant CurrentSince Sep 13, 2021 Accepting new patients
Ortho Kentucky Dba Kentucky Bone & Joint Surgeons Physician Assistant CurrentSince Sep 13, 2021 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Aug 1, 2020 Accepting new patients
Ortho Kentucky PLLC Past Accepting new patients

Locations

1740 Nicholasville Rd
Lexington, KY 40503
Phone (859) 260-6100

216 Fountain Ct
Ste 250
Lexington, KY 40509
Phone (859) 276-5008

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

Interoperability endpoints

  • Direct secure messaging: cdruien133784@bhkydirect.com
  • Direct secure messaging: kristynbossle@ok.allscriptsdirect.net

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1093339913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "LONDON",
            "state": "KY",
            "postal_code": "407430936",
            "telephone_number": "606-330-7835",
            "fax_number": "859-543-0994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 N EAGLE CREEK DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092121",
            "telephone_number": "859-264-9820",
            "fax_number": "859-543-0994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "216 Fountain Ct, 216",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405092510",
            "country_code": "US",
            "telephone_number": "859-276-5008",
            "fax_number": "859-278-6401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DULLAGHAN",
        "first_name": "KRISTYN",
        "middle_name": "J.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100681320",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTYN",
            "last_name": "BOSSLE",
            "middle_name": "J.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.