Individual provider Active NPI

Stephen Housman Kahler, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Carrollton, GA
National Provider Identifier
1023008794
Registry record updated Oct 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
030330 Issued in GA
Practice address
150 Henry Burson Ave
Suite 200
Carrollton, GA 30117-4465
Phone
(770) 834-6302
Fax
(770) 834-7660
NPI assigned
Oct 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X 030330 GA Primary

Addresses

Primary practice location

150 Henry Burson Ave
Suite 200
Carrollton, GA 30117-4465

Mailing address

119 Ambulance Dr Ste 202
Carrollton, GA 30117-3857
Phone (770) 834-6302

Other identifiers 1

IdentifierTypeStateIssuer
003154371MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101012000748 GA Practitioner - Plastic and Reconstructive Surgery 3678626009 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
030330GAMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Medical Group Inc CurrentSince Dec 6, 2014 Accepting new patients
TMC Villa Rica Hospital, Inc PastSince Jun 1, 2009 Accepting new patients
Plastic Surgery Center of West Georgia Past Accepting new patients

Locations

119 Ambulance Dr
Ste 202
Carrollton, GA 30117
Phone (770) 838-8710

157 Clinic Ave
Ste 302A
Carrollton, GA 30117
Phone (770) 812-5886

706 Dixie St
Ste 220
Carrollton, GA 30117
Phone (770) 812-8825

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507161600000",
    "number": "1023008794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 AMBULANCE DR STE 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173857",
            "telephone_number": "770-834-6302",
            "fax_number": "770-834-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 HENRY BURSON AVE",
            "address_2": "SUITE 200",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174465",
            "telephone_number": "770-834-6302",
            "fax_number": "770-834-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHLER",
        "first_name": "STEPHEN",
        "middle_name": "HOUSMAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2017-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "GA",
            "license": "030330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003154371",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.