Individual provider Active NPI

Kathryn E Calhoun, PA-C

  • Physician Assistant
  • Bloomington, IN
National Provider Identifier
1417288325
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10004501A Issued in IN
Practice address
2605 E Creeks Edge Dr
Bloomington, IN 47401-8368
Phone
(812) 333-2663
Fax
(812) 676-4131
NPI assigned
Jan 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10004501A IN Primary
Medical Physician Assistant 363AM0700X OA002432 PA
Medical Physician Assistant 363AM0700X MA54269 PA
Physician Assistant 363A00000X 0010-11127 NC

Addresses

Primary practice location

2605 E Creeks Edge Dr
Bloomington, IN 47401-8368

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other practice location 1

2817 Reilly St
Fort Bragg, NC 28310-7324
Phone (910) 907-2778

Other identifiers 2

IdentifierTypeStateIssuer
12078131OtherCAQH
05032086MedicaidNY

Other names 1

  • Kathryn Doremus Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kcalhoun@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20241123000254 IN Practitioner - Physician Assistant 6507035714 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

2209 John R Wooden Dr
Indiana University So in Phy Inc
Martinsville, IN 46151-1840
Phone (888) 484-3258

2605 E Creeks Edge Dr
Indiana University So in Phy Inc
Bloomington, IN 47401-8368
Phone (888) 484-3258

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9250

707 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

719 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

727 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
020389NYMDClinical Neuropsychologist
10004501AINMDPhysician Assistant
0010-11127NCMDPhysician Assistant
MA54269PAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Southern Indiana Physicians, LLC Physician Assistant CurrentSince Jan 13, 2025 Accepting new patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Jan 13, 2025 Accepting new patients
Iu Health Medical Group, LLC Physician Assistant CurrentSince Jan 1, 2026 Accepting new patients
Claxton-Hepburn Medical Center Past Accepting new patients

Locations

9149 State Road 37
Bedford, IN 47421
Phone (812) 276-2400

2605 E Creeks Edge Dr
Bloomington, IN 47401
Phone (812) 333-2663

2651 E Discovery Pkwy
Bloomington, IN 47408
Phone (812) 353-9147

2800 Rex Grossman Blvd
Bloomington, IN 47403
Phone (800) 841-4938

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

2209 John R Wooden Dr
Martinsville, IN 46151
Phone (765) 342-3364

100 Maple Leaf Blvd
Nashville, IN 47448
Phone (812) 333-2663

Interoperability endpoints

  • Direct secure messaging: kcalhoun@direct.iuhealth.org

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1263772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736899200000",
    "number": "1417288325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 E CREEKS EDGE DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474018368",
            "telephone_number": "812-333-2663",
            "fax_number": "812-676-4131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2817 Reilly St",
            "address_purpose": "LOCATION",
            "city": "Fort Bragg",
            "state": "NC",
            "postal_code": "283107324",
            "country_code": "US",
            "telephone_number": "910-907-2778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CALHOUN",
        "first_name": "KATHRYN",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-18",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10004501A",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "OA002432",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA54269",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11127",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12078131",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05032086",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kcalhoun@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2605 E Creeks Edge Dr",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474018368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "DOREMUS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.