Individual provider Active NPI

Kristen Claire Dohm, PA-C

  • Physician Assistant
  • Nashville, TN
National Provider Identifier
1295440998
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA62554 Issued in CA
Practice address
609 Shadow Glen Dr
Nashville, TN 37211-7527
Phone
(520) 289-6780
NPI assigned
Jan 17, 2023
Last updated
Jun 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 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 PA62554 CA Primary

Addresses

Primary practice location

609 Shadow Glen Dr
Nashville, TN 37211-7527

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (888) 663-6331

Other practice location 1

2 Embarcadero Ctr
San Francisco, CA 94111-3823
Phone (888) 663-6331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20230620002720 CA Practitioner - Physician Assistant 8921466194 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA62554CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network CurrentSince May 15, 2023 Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network CurrentSince May 15, 2023 Accepting new patients
Family Healthcare Network Current Accepting new patients
Family Healthcare Network Past Accepting new patients

Locations

305 E Center Ave
Visalia, CA 93291
Phone (559) 737-4792

201 E Lakeview Ave
Woodlake, CA 93286
Phone (559) 564-0100

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCECCA

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1673913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1295440998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "888-663-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 SHADOW GLEN DR",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372117527",
            "telephone_number": "520-289-6780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Embarcadero Ctr",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941113823",
            "country_code": "US",
            "telephone_number": "888-663-6331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOHM",
        "first_name": "KRISTEN",
        "middle_name": "CLAIRE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-17",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA62554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.