Individual provider Active NPI

Kristopher Ryan Kohout

  • Physician Assistant
  • Athens, TX
National Provider Identifier
1164032355
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA17918 Issued in TX
Practice address
1115 E Tyler St
Athens, TX 75751-2145
Phone
(903) 292-5015
Fax
(903) 292-5021
NPI assigned
Aug 3, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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 PA17918 TX Primary

Addresses

Primary practice location

1115 E Tyler St
Athens, TX 75751-2145

Mailing address

PO Box 95559
Grapevine, TX 76099-9707
Phone (405) 724-0574

Other practice location 1

110 S Main St
Boiling Springs, NC 28017-9797
Phone (704) 406-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TX2 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
I20210928003762 NC Practitioner - Physician Assistant 1153728472 Reassigns benefits to 3 organizations
I20250416000619 TX Practitioner - Physician Assistant 1153728472 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DCS Medical PAGroup PAC ID 0042507600, 155 clinicians
Value Urgent Care Clinics of Texas PLLCGroup PAC ID 4082997861, 4 clinicians

Practice addresses (Care Compare)

1115 E Tyler St
Integrity Urgent Care
Athens, TX 75751-2145
Phone (903) 292-5015

1208 W Henderson St
Cleburne, TX 76033-8731
Phone (682) 317-1500

2857 W Washington St
Stephenville, TX 76401-3706
Phone (254) 965-5273

3201 University Dr E
135 Integrity Urgent Care
Bryan, TX 77802-3481
Phone (979) 703-1832

805 Hill Blvd
Unit 102
Granbury, TX 76048-1482
Phone (682) 205-3690

808 N Nolan River Rd
Integrity Urgent Care
Cleburne, TX 76033-7012
Phone (817) 526-5509

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
DCS Medical PA CurrentSince Oct 22, 2025 Accepting new patients
DCS Medical PA CurrentSince Oct 22, 2025 Accepting new patients
Ballantyne Emergency Physicians PLLC Past Accepting new patients

Locations

1115 E Tyler St
Athens, TX 75751
Phone (903) 292-5015

3201 University Dr E
Ste 135
Bryan, TX 77802
Phone (979) 703-1832

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 6

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": "1596412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1164032355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95559",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760999707",
            "telephone_number": "405-724-0574",
            "fax_number": "405-849-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 E TYLER ST",
            "city": "ATHENS",
            "state": "TX",
            "postal_code": "757512145",
            "telephone_number": "903-292-5015",
            "fax_number": "903-292-5021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 S Main St",
            "address_purpose": "LOCATION",
            "city": "Boiling Springs",
            "state": "NC",
            "postal_code": "280179797",
            "country_code": "US",
            "telephone_number": "704-406-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOHOUT",
        "first_name": "KRISTOPHER",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-03",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA17918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, TX

Sources for this page

Verify at the official NPI Registry.