Individual provider Active NPI

Kristopher Dolehanty, PA-C

  • Physician Assistant
  • Kennesaw, GA
National Provider Identifier
1487148268
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10809 Issued in GA
Practice address
2782 N Cobb Pkwy
Kennesaw, GA 30152-3472
Phone
(770) 420-1092
NPI assigned
Jun 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 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 10809 GA Primary

Addresses

Primary practice location

2782 N Cobb Pkwy
Kennesaw, GA 30152-3472

Mailing address

2782 N Cobb Pkwy
Kennesaw, GA 30152-3472
Phone (770) 420-1092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20241127001804 GA Practitioner - Physician Assistant 1254780281 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Nebraska College of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care PLLCGroup PAC ID 0941642169, 19 clinicians
Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

11710 Alpharetta Hwy
Roswell, GA 30076-3807
Phone (866) 389-2727

1380 Woodstock Rd
Roswell, GA 30075-2141
Phone (866) 389-2727

1600 Towne Lake Pkwy
Woodstock, GA 30189-1585
Phone (866) 389-2727

2455 Paces Ferry Rd SE
Atlanta, GA 30339-1834
Phone (866) 389-2727

2782 N Cobb Pkwy
Kennesaw, GA 30152-3472
Phone (866) 389-2727

3905 Due W Rd NW
Marietta, GA 30064-1019
Phone (866) 389-2727

4300 Paces Ferry Rd SE
Atlanta, GA 30339-5705
Phone (866) 389-2727

4895 Post Rd
Cumming, GA 30040-4978
Phone (866) 389-2727

495 Charles Hardy Pkwy
Dallas, GA 30157-5723
Phone (866) 389-2727

6120 Hickory Flat Hwy
Canton, GA 30115-7252
Phone (866) 389-2727

687 Johnson Ferry Rd
Marietta, GA 30068-4628
Phone (866) 389-2727

800 E W Connector
Austell, GA 30106-1358
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10809GAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Physician Assistant CurrentSince Aug 26, 2025 Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC PastSince Nov 1, 2024 Accepting new patients
Aylo Health, LLC Past Accepting new patients

Locations

2782 N Cobb Pkwy NW
Kennesaw, GA 30152
Phone (770) 420-1092

11710 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 754-0141

7207 Rockbridge Rd
Stone Mtn, GA 30087
Phone (770) 469-2002

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722

Organizations & group practices 6

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": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1487148268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2782 N COBB PKWY",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523472",
            "telephone_number": "770-420-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2782 N COBB PKWY",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523472",
            "telephone_number": "770-420-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLEHANTY",
        "first_name": "KRISTOPHER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-15",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.