KRISTINA MAIN (NPI# 1104392588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104392588 |
| Entity Type | Individual |
| Full Name | KRISTINA MAIN |
| Other Name | KRISTINA ALYSE KOHUTH |
| Credential | PA-C |
| Practice Address |
1402 Wayne Memorial Dr Goldsboro NC 27534-2235 |
| Mailing Address |
3712 Greenville Loop Rd Wake Forest NC 27587-5616 |
| Practice Telephone | 7724860807 |
| Mailing Telephone | 7724860807 |
| Enumeration Date | 2018-10-23 |
| Last Update Date | 2018-10-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306089545 | Kristina G. Main | Physical Therapist | 1506 S Oneida St, Appleton, WI 54915-1305 | 2009-04-17 |
| Street Address |
1402 WAYNE MEMORIAL DR |
| City | GOLDSBORO |
| State | NC |
| Zip Code | 27534-2235 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679551949 | Wilson Egbe Tabe | Family Medicine | 1402 Wayne Memorial Dr, Goldsboro, NC 27534-2252 | 2006-01-05 |
| 1831738178 | Charmay Deneen Fryar-robinson | Nurse Practitioner | 1402 Wayne Memorial Dr, Goldsboro, NC 27534-2235 | 2020-01-03 |
| 1134781511 | Gladys Kerubo Nyaruri | Nurse Practitioner | 1402 Wayne Memorial Dr, Goldsboro, NC 27534-2235 | 2019-07-05 |
| 1316405988 | Arit Niger-thomas Ekobena | Nurse Practitioner | 1402 Wayne Memorial Dr, Goldsboro, NC 27534-2235 | 2019-03-03 |
| 1457855405 | Amanda Tucker Gay | Nurse Practitioner | 1402 Wayne Memorial Dr, Goldsboro, NC 27534-2235 | 2018-03-22 |
| 1003356767 | Samantha Joanne Criste | Nurse Practitioner | 1402 Wayne Memorial Dr, Goldsboro, NC 27534-2235 | 2017-02-28 |
| 1780031542 | Medical Care Inc | Health Maintenance Organization | 1402 Wayne Memorial Dr, Goldsboro, NC 27534-2235 | 2016-05-20 |
| 1396186508 | Medical Care Sleep Lab | Family Medicine | 1402 Wayne Memorial Dr, Goldsboro, NC 27534-2235 | 2013-07-16 |
| 1962673673 | Medical Care Inc | Family Medicine | 1402 Wayne Memorial Dr, Goldsboro, NC 27534-2235 | 2008-03-20 |
| 1609064948 | Support Care LLC | Community/Behavioral Health | 1402 Wayne Memorial Dr, Goldsboro, NC 27534-1858 | 2007-10-11 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457875767 | Trent Jonathan Forshey | Physical Therapist | 2126 Wayne Memorial Dr, Goldsboro, NC 27534 | 2017-07-28 |
| 1336685551 | Wayne Al Holdings, LLC | Assisted Living Facility | 901 West New Hope Rd, Goldsboro, NC 27534 | 2017-01-11 |
| 1952845471 | Latoya Faulk | Social Worker | 121 Carolina Forest Drive, Goldsboro, NC 27534 | 2016-12-19 |
| 1528415841 | Kelby Joseph Sage Durnin | Military Health Care Provider | 1020 Jabara Avenue, Seymour Johnson Afb, NC 27534 | 2016-05-17 |
| 1528490604 | Eric Christian Bourgeois | Physical Therapist | 1101a Gracie Pl, Goldsboro, NC 27534 | 2013-07-31 |
| 1831439165 | Erica Nicole Davis | Optometrist | 20/20 Vision Center 625 North Berkeley Blvd, Suite D, Goldsboro, NC 27534 | 2013-02-23 |
| 1891039236 | Betty Webb Zimmerman | Nurse Practitioner | 204 Cox Blvd, Goldsboro, NC 27534 | 2012-11-26 |
| 1144595265 | Life Recovery Psychological Services | Counselor | 1202-c Wayne Memorial Dr, Goldsboro, NC 27534 | 2012-03-22 |
| 1558596536 | Taylor Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 802 Taylor St, Goldsboro, NC 27534 | 2009-05-20 |
| 1780895136 | Sherrie Fennell Edwards | Dietitian, Registered | 1500 Lanely Ave., Seymour Johnson Afb, Golsboro, NC 27534 | 2007-05-25 |
| Find all providers in zip 27534 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346784949 | Brenda A Scronce | Physician Assistant | 211 N Spence Ave, Goldsboro, NC 27534-2753 | 2016-12-15 |
| 1114383528 | Katlyn E Rhodes | Physician Assistant | 1506 Wayne Memorial Dr Ste D, Goldsboro, NC 27534-2202 | 2016-01-14 |
| 1093900466 | Diane Lancaster Mullins | Physician Assistant | 901 Beech St, Goldsboro, NC 27530-2922 | 2007-09-10 |
| 1346321759 | David Mcdonald Hinds | Physician Assistant | 2902 Central Heights Rd, Goldsboro, NC 27534-6513 | 2006-10-18 |
| 1962506246 | Teresa Jean Cochran | Physician Assistant | 1100 Parkway Dr Suite C, Goldsboro, NC 27534 | 2006-09-08 |
| 1104932433 | Sharon G. Crenshaw | Physician Assistant | 301 N Herman Street Box Cc, Goldsboro, NC 27530-1056 | 2006-08-21 |
| 1730709957 | Sarah Heminger | Physician Assistant | 104c Adair Dr, Goldsboro, NC 27530-4516 | 2020-04-17 |
| 1508417809 | Kaitlyn Jessica Shotwell | Physician Assistant | 2700 Wayne Memorial Dr, Goldsboro, NC 27534-9494 | 2019-09-27 |
| 1861040230 | Aaron Stephen Peterson | Physician Assistant | 2600 Us Highway 70 W, Goldsboro, NC 27530-7779 | 2019-08-29 |
| 1376026518 | Matthew Price Mclaughlin | Physician Assistant | 2700 Wayne Memorial Dr, Goldsboro, NC 27534-9494 | 2018-09-13 |
| Find all providers in GOLDSBORO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.