Active NPI
Katryn Marie Parillo, CSA
- Surgical Physician Assistant
- Woodstock, GA
National Provider Identifier
1073048286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 4769
- Practice address
- 403 Woodchase Way
Woodstock, GA 30188-2052 - Phone
- (678) 956-1272
- NPI assigned
- Apr 25, 2017
- Last updated
- Jun 6, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 4769 | DC | Primary |
| Surgical Assistant | 246ZC0007X | CSA# 4769 | DC |
Addresses
Primary practice location
403 Woodchase Way
Woodstock, GA 30188-2052
Mailing address
403 Woodchase Way
Woodstock, GA 30188-2052
Phone (678) 956-1272
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSA# 4769 | DC | MD | Surgical Assistant |
| 4769 | DC | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654473600000",
"number": "1073048286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "403 WOODCHASE WAY",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301882052",
"telephone_number": "678-956-1272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 WOODCHASE WAY",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301882052",
"telephone_number": "678-956-1272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARILLO",
"first_name": "KATRYN",
"middle_name": "MARIE",
"credential": "CSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-25",
"last_updated": "2022-06-06",
"certification_date": "2022-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "DC",
"license": "4769",
"primary": true
},
{
"code": "246ZC0007X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Other, Surgical Assistant",
"state": "DC",
"license": "CSA# 4769",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Woodstock, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.