Individual provider Active NPI

Kristen Spano, PA

  • Physician Assistant
  • Nashville, TN
National Provider Identifier
1508241563
Registry record updated May 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3571 Issued in TN
Practice address
1020 Dr. M.L.K. Jr. Blvd
Nashville, TN 37203
Phone
(615) 622-4644
NPI assigned
Jul 20, 2015
Last updated
May 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 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 3571 TN Primary

Addresses

Primary practice location

1020 Dr. M.L.K. Jr. Blvd
Nashville, TN 37203

Mailing address

2413 Booker St # B
Nashville, TN 37208-3430
Phone (716) 908-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160115002028 NY Practitioner - Physician Assistant 9436452950 Reassigns benefits to 2 organizations
I20190626004096 TN Practitioner - Physician Assistant 9436452950 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
018836NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Erie Comptrollers Office CurrentSince Aug 26, 2017 Accepting new patients
Ub Family Medicine, Inc Current Accepting new patients
Music City Physicians Group PLLC PastSince Oct 1, 2022 Accepting new patients
Music City Prep Clinic PastSince Mar 12, 2024 Accepting new patients

Locations

95 Franklin St
Rm 906
Buffalo, NY 14202

608 William St
Buffalo, NY 14206
Phone (716) 855-1384

462 Grider St
Cheektowaga, NY 14215
Phone (716) 831-8612

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17956/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kristen.spano.1@17956.direct.athenahealth.com

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, 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": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1508241563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2413 BOOKER ST # B",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372083430",
            "telephone_number": "716-908-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 DR. M.L.K. JR. BLVD",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37203",
            "telephone_number": "615-622-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANO",
        "first_name": "KRISTEN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-20",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.