Individual provider Active NPI

Kathrin Khatereh Nunes, PAC

  • Physician Assistant
  • Chattanooga, TN
National Provider Identifier
1881769305
Registry record updated Oct 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1247 Riverfront Pkwy Ste 205
Chattanooga, TN 37402-2108
Phone
(423) 521-4232
Fax
(423) 521-4235
NPI assigned
Nov 21, 2006
Last updated
Oct 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 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 NU Primary

Addresses

Primary practice location

1247 Riverfront Pkwy Ste 205
Chattanooga, TN 37402-2108

Mailing address

1247 Riverfront Pkwy Ste 205
Chattanooga, TN 37402-2108
Phone (423) 521-4232

Other names 1

  • Kathrin Vodjdani Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20120222000695 TN Practitioner - Physician Assistant 2769640788 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Four Bridges Dermatology and Cosmetics PLLCGroup PAC ID 0345636189, 6 clinicians

Practice addresses (Care Compare)

1247 Riverfront Pkwy
Suite 205
Chattanooga, TN 37402-2108
Phone (606) 344-2036

Merit-based Incentive Payment System (MIPS)

Final score
94.27 of 100Reported as apm
Quality
92.6
Promoting interoperability
93.23
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aesthetic Dermatology & Surgery Clinique, Inc PastSince Jul 1, 1998 Accepting new patients

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, 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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760054400000",
    "number": "1881769305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1247 RIVERFRONT PKWY STE 205",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374022108",
            "telephone_number": "423-521-4232",
            "fax_number": "423-521-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1247 RIVERFRONT PKWY STE 205",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374022108",
            "telephone_number": "423-521-4232",
            "fax_number": "423-521-4235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNES",
        "first_name": "KATHRIN",
        "middle_name": "KHATEREH",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-10-10",
        "certification_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRIN",
            "last_name": "VODJDANI",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.