Kaitlin M Atwater, PA-C
Individual provider Active NPI Physician Assistant · Fort Meade, SD
NPI 1013215672 · NPPES record last updated Apr 17, 2024
Key facts
- NPI
- 1013215672
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0772 (SD)
- Practice address
- 113 Comanche Rd
Fort Meade, SD 57741-1002 - Phone
- (605) 720-7449
- NPI assigned
- Mar 7, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0772 | SD | Yes |
Addresses
Primary practice location
113 Comanche Rd
Fort Meade, SD 57741-1002
Mailing address
113 Comanche Rd
Fort Meade, SD 57741-1002
Phone (605) 720-7449
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6832630 | Medicaid | SD |
Other providers in Fort Meade, SD
- Amy Andress
- Joelle A Archer
- Christina Arrechavala
- Kalee Arsaga
- Angela Gail Arseneau
- Carlie Atwood
- Cynthia Lampa Austin
- Heather Marie Baker
- Sandra Baldwin
- Michael S. Ballek
All providers in Fort Meade, SD · Physician Assistant in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.