Individual provider Active NPI

Kathryn Kaufman, PA-C

  • Physician Assistant
  • Durham, NC
National Provider Identifier
1699653238
Registry record updated May 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-16094 Issued in NC
Practice address
5501 Fortunes Ridge Dr Ste P
Durham, NC 27713-6102
Phone
(919) 391-7202
NPI assigned
Aug 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13400 GA
Physician Assistant 363A00000X 0010-16094 NC Primary

Addresses

Primary practice location

5501 Fortunes Ridge Dr Ste P
Durham, NC 27713-6102

Mailing address

5501 Fortunes Ridge Dr Ste P
Durham, NC 27713-6102
Phone (919) 391-7202

Other practice location 1

45 South Ave SE Ste 5
Marietta, GA 30060-2538
Phone (919) 391-7202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20260422000484 NC Practitioner - Physician Assistant 5092282590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

505 Wellingham Dr
Durham, NC 27713-7501

5501 Fortunes Ridge Dr
Suite P
Durham, NC 27713-6102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0010-16094NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Animo Sano Psychiatry PLLC CurrentSince Nov 15, 2023 Accepting new patients

Locations

45 South Ave SE
Ste 5
Marietta, GA 30060

5501 Fortunes Ridge Dr
Ste P
Durham, NC 27713
Phone (919) 319-7202

Organizations & group practices 1

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": "1755820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777852800000",
    "number": "1699653238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 FORTUNES RIDGE DR STE P",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136102",
            "telephone_number": "919-391-7202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 FORTUNES RIDGE DR STE P",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277136102",
            "telephone_number": "919-391-7202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 South Ave SE Ste 5",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300602538",
            "country_code": "US",
            "telephone_number": "919-391-7202",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUFMAN",
        "first_name": "KATHRYN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-22",
        "last_updated": "2026-05-04",
        "certification_date": "2026-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "13400",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-16094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.