Kathryn J. Wrynn, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0489 Issued in NH

Practice address

89 S Mast St
Goffstown, NH 03045-6102

Phone

(603) 537-1300

Fax

(603) 505-8422

NPI assigned

Jun 16, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NH

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

Specialty

Physician Assistant

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Derry Medical Center, PAGroup PAC ID 5294711768, 98 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: kathrynwrynn@dmcnh.allscriptsdirect.net

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.

• Derry Medical Center, PA

  • Family Medicine Physician
  • Derry, NH
  • NPI 1922030493
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1982609814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BUTTRICK RD STE 102",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533417",
            "telephone_number": "603-537-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 S MAST ST",
            "city": "GOFFSTOWN",
            "state": "NH",
            "postal_code": "030456102",
            "telephone_number": "603-537-1300",
            "fax_number": "603-505-8422"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "81 Hall St",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NH",
            "postal_code": "033013420",
            "country_code": "US",
            "telephone_number": "603-537-1300",
            "fax_number": "603-415-9993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRYNN",
        "first_name": "KATHRYN",
        "middle_name": "J.",
        "name_prefix": "Ms.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-16",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "0489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREATWEST HEALTHCARE",
            "identifier": "222594672",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30334857",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "222594672",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kevan Wesley Walker
• Jill M. Waren, MD
• Steven D Wehrli, DDS
• Kathleen Welch
• Marissa Lynn Williams, AGNP-C

• Medical Physician Assistant in Goffstown, NH
• Providers in Goffstown, NH by specialty
• Medical Physician Assistant in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.