Individual provider Active NPI

Kristen R Rahn, MD

  • Family Medicine Physician
  • Sarasota, FL
National Provider Identifier
1457377244
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME143191 Issued in FL
Practice address
5880 Rand Blvd Ste 200
Sarasota, FL 34238
Phone
(941) 917-2300
Fax
(941) 923-1453
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 41442 WI
Family Medicine Physician 207Q00000X ME143191 FL Primary

Addresses

Primary practice location

5880 Rand Blvd Ste 200
Sarasota, FL 34238

Mailing address

PO Box 863407
Orlando, FL 32886-3407
Phone (941) 917-2600

Other practice location 1

4005 Community Center Dr
Weston, WI 54476-4139
Phone (715) 241-5400

Other practice location 2

4005 Community Center Dr
Weston, WI 54476-4139
Phone (715) 241-5400

Other identifiers 1

IdentifierTypeStateIssuer
34025400MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191231002106 FL Practitioner - Family Practice 5496836892 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME143191FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SMH Physician Services Inc Family Medicine CurrentSince Jan 13, 2020 Accepting new patients
Aspirus Wausau Hospital, Inc. PastSince Sep 1, 2018 Accepting new patients

Locations

1921 Waldemere St
Ste 307
Sarasota, FL 34239
Phone (941) 917-8565

5880 Rand Blvd
Ste 200
Sarasota, FL 34238
Phone (941) 917-2300

Organizations & group practices 2

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": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1457377244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863407",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863407",
            "telephone_number": "941-917-2600",
            "fax_number": "941-917-7884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 RAND BLVD STE 200",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34238",
            "telephone_number": "941-917-2300",
            "fax_number": "941-923-1453"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4005 Community Center Dr",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "WI",
            "postal_code": "544764139",
            "country_code": "US",
            "telephone_number": "715-241-5400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4005 Community Center Dr",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "WI",
            "postal_code": "544764139",
            "country_code": "US",
            "telephone_number": "715-241-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAHN",
        "first_name": "KRISTEN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "41442",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME143191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34025400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

Verify at the official NPI Registry.