Individual provider Active NPI

Kristina Kohuth, PA-C

  • Physician Assistant
  • Raleigh, NC
National Provider Identifier
1104392588
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-08570 Issued in NC
Practice address
3001 Edwards Mill Rd Ste 200
Raleigh, NC 27612-5243
Phone
(919) 781-5600
NPI assigned
Oct 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0010-08570 NC
Physician Assistant 363A00000X 0010-08570 NC Primary

Addresses

Primary practice location

3001 Edwards Mill Rd Ste 200
Raleigh, NC 27612-5243

Mailing address

3001 Edwards Mill Rd Ste 200
Raleigh, NC 27612-5243
Phone (919) 781-5600

Other practice location 1

1325 Timber Dr E
Garner, NC 27529-6924
Phone (919) 781-5600

Other practice location 2

421 Fayetteville St Ste 1100
Raleigh, NC 27601-3000
Phone (919) 858-6767

Other names 1

  • Kristina Alyse Main Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20190219002538 NC Practitioner - Physician Assistant 9133467012 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orthopaedic Specialists of North Carolina, P.a.Group PAC ID 7810974375, 49 clinicians
American Family Care Fuquay PLLCGroup PAC ID 6103258306, 33 clinicians
Raleigh Orthopaedic Clinic PAGroup PAC ID 9032012638, 125 clinicians

Practice addresses (Care Compare)

11221 Galleria Ave
Suite 101
Raleigh, NC 27614-8137
Phone (919) 562-9410

1298 N Main St
Fuquay Varina, NC 27526-2615
Phone (919) 590-4099

1325 Timber Dr E
Garner, NC 27529-6924
Phone (919) 781-5600

2000 S Horner Blvd
Sanford, NC 27330-5818
Phone (919) 352-9538

2100 W Cumberland St
Dunn, NC 28334-4446
Phone (910) 304-0112

2200 Treelight Way
Wendell, NC 27591-3200
Phone (919) 374-0900

Merit-based Incentive Payment System (MIPS)

Final score
83.06 of 100Reported as group
Quality
61.01
Promoting interoperability
100
Improvement activities
40
Cost
82.52

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-08570NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Gem Wellness & Integrative Medicine PLLC Family Medicine Current Accepting new patients
Orthopaedic Specialists of North Carolina, P.a. CurrentSince Jan 13, 2023 Accepting new patients

Locations

6602 Knightdale Blvd
Ste 310
Knightdale, NC 27545

5838 Six Forks Rd
Ste 100
Raleigh, NC 27609

11200 Governor Manly Way
Ste 309
Raleigh, NC 27614
Phone 9195629410247

421 Fayetteville St
Ste 1100
Raleigh, NC 27601
Phone (910) 421-0007

11221 Galleria Ave
#101
Raleigh, NC 27614
Phone 9195629410213

1936 Golden Spur Ln
Wendell, NC 27591

Interoperability endpoints

  • Direct secure messaging: kristina.kohuth.1@12529.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1104392588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 EDWARDS MILL RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125243",
            "telephone_number": "919-781-5600",
            "fax_number": "919-576-1731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 EDWARDS MILL RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276125243",
            "telephone_number": "919-781-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1325 Timber Dr E",
            "address_purpose": "LOCATION",
            "city": "Garner",
            "state": "NC",
            "postal_code": "275296924",
            "country_code": "US",
            "telephone_number": "919-781-5600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "421 Fayetteville St Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276013000",
            "country_code": "US",
            "telephone_number": "919-858-6767",
            "fax_number": "919-576-1731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOHUTH",
        "first_name": "KRISTINA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "0010-08570",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINA",
            "last_name": "MAIN",
            "middle_name": "ALYSE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.