Individual provider Active NPI

Kaitlin Gutenson Martin, PA

  • Physician Assistant
  • Forest, VA
National Provider Identifier
1760178172
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1175 Corporate Park Dr
Forest, VA 24551-2238
Phone
(434) 525-6964
NPI assigned
Apr 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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 Primary

Addresses

Primary practice location

1175 Corporate Park Dr
Forest, VA 24551-2238

Mailing address

81 Sweetwater Rd
Lynchburg, VA 24501-7721
Phone (703) 268-3983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA2 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
I20240523000026 DC Practitioner - Physician Assistant 8820450075 Reassigns benefits to 1 organization
I20240702004688 VA Practitioner - Physician Assistant 8820450075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

205 Archway CT
Lynchburg, VA 24502-3159
Phone (434) 382-1123

8644 Sudley Rd
Suite 220
Manassas, VA 20110-4425
Phone (571) 366-8845

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Jun 3, 2024 Accepting new patients
Privia Medical Group, LLC CurrentSince Jun 3, 2024 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

131 Jones St
Appomattox, VA 24522
Phone (434) 332-7367

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

1175 Corporate Park Dr
Forest, VA 24551
Phone (434) 525-6964

1088 London Links Dr
Forest, VA 24551
Phone (434) 534-6868

527 Pocket Rd
Hurt, VA 24563
Phone (434) 324-9150

14005 Wards Rd
#A
Lynchburg, VA 24501
Phone (434) 239-0132

2019 Tate Springs Rd
Lowr
Lynchburg, VA 24501
Phone (434) 846-7708

2321 Wards Rd
Lynchburg, VA 24502
Phone (434) 582-2273

205 Archway Ct
Lynchburg, VA 24502

2215 Landover Pl
Lynchburg, VA 24501
Phone (434) 947-3900

2215 Landover Pl
Lowr
Lynchburg, VA 24501

2019 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 845-7035

2137 Lakeside Dr
Ste 100
Lynchburg, VA 24501
Phone (434) 385-4184

118 Oakwood Dr
Madison Heights, VA 24572
Phone (434) 845-5641

8644 Sudley Rd
#220
Manassas, VA 20110

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: kaitlin.gutenson.1@8042.direct.athenahealth.com

Organizations & group practices 3

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": "1681776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1760178172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 SWEETWATER RD",
            "city": "LYNCHBURG",
            "state": "VA",
            "postal_code": "245017721",
            "telephone_number": "703-268-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 CORPORATE PARK DR",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512238",
            "telephone_number": "434-525-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KAITLIN",
        "middle_name": "GUTENSON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-18",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest, VA

Sources for this page

Verify at the official NPI Registry.