Individual provider Active NPI

Katherine L Krahe, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1164706628
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4955 Issued in AZ
Practice address
13838 S 46TH PL
Suite 125
Phoenix, AZ 85044-7800
Phone
(480) 783-7000
Fax
(480) 753-5952
NPI assigned
Oct 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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 4955 AZ Primary

Addresses

Primary practice location

13838 S 46TH PL
Suite 125
Phoenix, AZ 85044-7800

Mailing address

13838 S 46TH PL
Suite 125
Phoenix, AZ 85044-7800
Phone (480) 783-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20220329001942 AZ Order and Referring Only - Physician Assistant 7719121540

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4955AZMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1164706628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13838 S 46TH PL",
            "address_2": "SUITE 125",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850447800",
            "telephone_number": "480-783-7000",
            "fax_number": "480-753-5952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13838 S 46TH PL",
            "address_2": "SUITE 125",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850447800",
            "telephone_number": "480-783-7000",
            "fax_number": "480-753-5952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAHE",
        "first_name": "KATHERINE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-03",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "4955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.