Individual provider Active NPI

Athena Karin Craven, P.A

  • Physician Assistant
  • Irving, TX
National Provider Identifier
1316495187
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18446 Issued in TX
Practice address
4520 N Macarthur Blvd Ste 100
Irving, TX 75038-1235
Phone
(214) 630-5256
NPI assigned
Sep 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 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 PA18446 TX Primary

Addresses

Primary practice location

4520 N Macarthur Blvd Ste 100
Irving, TX 75038-1235

Mailing address

4520 N Macarthur Blvd Ste 100
Irving, TX 75038-1235
Phone (214) 630-5256

Other names 1

  • Athena Karin White Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190416000637 NY Practitioner - Physician Assistant 1759622962 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA18446TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Blackburn Woolfolk Dermatology, PLLC CurrentSince Mar 20, 2025 Accepting new patients
Southwest Texas Two Medical Group, PLLC Past Accepting new patients

Locations

4520 N MacArthur Blvd
#100
Irving, TX 75038
Phone (214) 630-5256

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": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1316495187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 N MACARTHUR BLVD STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750381235",
            "telephone_number": "214-630-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 N MACARTHUR BLVD STE 100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750381235",
            "telephone_number": "214-630-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAVEN",
        "first_name": "ATHENA",
        "middle_name": "KARIN",
        "credential": "P.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-21",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ATHENA",
            "last_name": "WHITE",
            "middle_name": "KARIN",
            "credential": "P.A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Irving, TX

Sources for this page

Verify at the official NPI Registry.