Kenneth Bostic, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

003528 Issued in GA

Practice address

1061 Harmon Ave
Winn Army Community Hospital Ste1D03
Fort Stewart, GA 31314-5641

Phone

(912) 435-5254

NPI assigned

Jan 10, 2007

Last updated

Jun 11, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 GA

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, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chatham Orthopaedic Associates PAGroup PAC ID 8022910306, 55 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84 of 100Reported as group

Quality

65.06

Promoting interoperability

98

Improvement activities

40

Cost

83.28

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kenneth.bostic.1@18355.direct.athenahealth.com

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.

• Chatham Orthopaedic Associates, PA

  • Orthopaedic Surgery Physician
  • Savannah, GA
  • NPI 1366495814
  Medicare reassignment Care Compare group NPD (past)
• Effingham Orthopedic Practice, LLC

  dba Effingham Orthopaedic Center

  • Orthopaedic Surgery Physician
  • Rincon, GA
  • NPI 1013459551
  Medicare reassignment
• Chatham Orthopaedic Associates, PA

  • Orthopaedic Surgery Physician
  • Pooler, GA
  • NPI 1598153900
  NPD
• Chatham Orthopaedic Associates, PA

  dba Chatham Sports Medicine

  • Specialist
  • Savannah, GA
  • NPI 1710029137
  NPD
• Bryan Medical Associates,Inc

  • Internal Medicine Physician
  • Hinesville, GA
  • NPI 1154363927
  NPD (past)
• Coastal Orthopaedics and Sports Medicine Center

  • Specialist
  • Hinesville, GA
  • NPI 1255406328
  NPD (past)
• Savannah Heart,P.C.

  • Specialist
  • Savannah, GA
  • NPI 1700809688
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1043360597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "address_2": "WINN ARMY COMMUNITY HOSPITAL STE1D03",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 HARMON AVE",
            "address_2": "WINN ARMY COMMUNITY HOSPITAL STE1D03",
            "city": "FORT STEWART",
            "state": "GA",
            "postal_code": "313145641",
            "telephone_number": "912-435-5254"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 St Josephs Candler Dr Fl 1",
            "address_purpose": "LOCATION",
            "city": "Pooler",
            "state": "GA",
            "postal_code": "313229579",
            "country_code": "US",
            "telephone_number": "912-355-6615",
            "fax_number": "912-351-0645",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4425 Paulsen St",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "314053662",
            "country_code": "US",
            "telephone_number": "912-355-6615",
            "fax_number": "912-351-0645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSTIC",
        "first_name": "KENNETH",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "003528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "641480416A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "641480416B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "641480416C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jon-Christian Bonner
• Willy David Booker, PA-C
• Joshua Jay Borer, LCSW
• Michael Charles Borg, PH.D.
• Targhee Boss, DDS
• Michael William Bowdren, PH.D.
• Scott W. Bowling, P.A.
• Garrett Boyer, PSY.D.
• Jarum Michael Boyer, DMD
• Nykeba S Braddy, PA-C

• Physician Assistant in Fort Stewart, GA
• Providers in Fort Stewart, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.