Individual provider Active NPI

Kristal L Mylin, PA

  • Physician Assistant
  • Lebanon, IN
National Provider Identifier
1821405671
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001675A Issued in IN
Practice address
2605 N Lebanon St
Lebanon, IN 46052-1476
Phone
(765) 485-8000
NPI assigned
Jul 14, 2014
Last updated
Jul 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 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 10001675A IN Primary
Medical Physician Assistant 363AM0700X 10001675A IN

Addresses

Primary practice location

2605 N Lebanon St
Lebanon, IN 46052-1476

Mailing address

2605 N Lebanon St
Lebanon, IN 46052-1476

Other practice location 1

8904 Bash St Ste B
Indianapolis, IN 46256-1286
Phone (317) 735-6001

Other identifiers 1

IdentifierTypeStateIssuer
300012250MedicaidIN

Other names 1

  • Kristal L Gearhart Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmylin@withamdirect.org Health Information Exchange (HIE) Witham Memorial Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20140814000673 IN Practitioner - Physician Assistant 1951528975 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Witham Memorial HospitalGroup PAC ID 4082523170, 107 clinicians

Practice addresses (Care Compare)

2505 N Lebanon St
Lebanon, IN 46052-8613
Phone (765) 485-8830

2605 N Lebanon St
Lebanon, IN 46052-1476

6085 Heartland Dr
Zionsville, IN 46077-4433

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10001675AINMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Family Physicians, Inc. CurrentSince Sep 1, 2014 Accepting new patients
Witham Memorial Hospital CurrentSince Sep 25, 2023 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Dec 16, 2019 Accepting new patients
Indiana University Health Urgent Care Centers, LLC. CurrentSince Mar 19, 2018 Accepting new patients
Witham Memorial Hospital CurrentSince Sep 25, 2023 Accepting new patients
Indiana University Health Urgent Care Centers, LLC CurrentSince Mar 19, 2018 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Dec 16, 2019 Accepting new patients

Locations

5819 Reliable Pkwy
Chicago, IL 60686

7216 Solutions Ctr
Chicago, IL 60677

90 E Garner Rd
Brownsburg, IN 46112
Phone (225) 214-1031

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

550 University Blvd
#1501
Indianapolis, IN 46202
Phone (317) 948-1310

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

3500 S Lafountain St
Kokomo, IN 46902
Phone (765) 453-0702

2505 N Lebanon St
Ste 220
Lebanon, IN 46052
Phone (765) 482-8649

2605 N Lebanon St
Lebanon, IN 46052
Phone (765) 485-8000

6085 Heartland Dr
Ste 204
Zionsville, IN 46077
Phone (317) 768-2134

Interoperability endpoints

  • Direct secure messaging: kmylin@withamdirect.org

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1821405671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 N LEBANON ST",
            "city": "LEBANON",
            "state": "IN",
            "postal_code": "460521476",
            "telephone_number": "765-485-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8904 Bash St Ste B",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462561286",
            "country_code": "US",
            "telephone_number": "317-735-6001",
            "fax_number": "855-450-1177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MYLIN",
        "first_name": "KRISTAL",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001675A",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IN",
            "license": "10001675A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300012250",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmylin@withamdirect.org",
            "affiliation": "Y",
            "affiliationName": "Witham Memorial Hospital",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2605 N Lebanon St",
            "city": "Lebanon",
            "state": "IN",
            "country_code": "US",
            "postal_code": "460521476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTAL",
            "last_name": "GEARHART",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lebanon, IN

Sources for this page

Verify at the official NPI Registry.