Individual provider Active NPI

Kristen Leeann Wahlen

  • Surgery Physician
  • Carson City, NV
National Provider Identifier
1790244606
Registry record updated Apr 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
DO4020 Issued in NV
Practice address
704 W Nye LN
Carson City, NV 89703-1576
Phone
(901) 831-5701
Fax
(901) 831-5701
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X DO4020 NV Primary

Addresses

Primary practice location

704 W Nye LN
Carson City, NV 89703-1576

Mailing address

3497 Alpine View CT
Carson City, NV 89705-7007
Phone (901) 831-5701

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kwahlen292269@student.wmcarey.edu William Carey University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20260521003886 NV Practitioner - General Surgery 0244566610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
William Carey University College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CTH Physicians ClinicGroup PAC ID 1254787203, 107 clinicians

Practice addresses (Care Compare)

2874 N Carson St
Suite 120
Carson City, NV 89706-1681
Phone (775) 445-5181

Hospital & facility affiliations

  • Carson Tahoe Regional Medical Center Hospital, Carson City, NV, CCN 290019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DO4020NVMDSurgery Physician

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1790244606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3497 ALPINE VIEW CT",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897057007",
            "telephone_number": "901-831-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 W NYE LN",
            "city": "CARSON CITY",
            "state": "NV",
            "postal_code": "897031576",
            "telephone_number": "901-831-5701",
            "fax_number": "901-831-5701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLEN",
        "first_name": "KRISTEN",
        "middle_name": "LEEANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NV",
            "license": "DO4020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwahlen292269@student.wmcarey.edu",
            "affiliation": "Y",
            "affiliationName": "William Carey University",
            "address_1": "710 William Carey Pkwy",
            "city": "Hattiesburg",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394017842",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Carson City, NV

Sources for this page

Verify at the official NPI Registry.