Kimberly Jaye McIntosh, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

053808 Issued in GA

Practice address

1050 Eagles Landing Pkwy
#302
Stockbridge, GA 30281

Phone

(770) 474-0064

Fax

(770) 474-2998

NPI assigned

Jul 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Obstetrics/Gynecology

Education

Columbia University College of Physicians and Surgeons, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Serena D. Tidwell, M.D., P.C.Group PAC ID 9931291226, 16 clinicians

Southern Crescent Womens Health Specialists at Eagle'S LandingGroup PAC ID 3072504240, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Serena D. Tidwell, M.D., P.C.

  • Point of Service
  • Columbus, GA
  • NPI 1689759581

  GA

  Medicare reassignment Care Compare group NPD
• Southern Crescent Womens Health Specialists at Eagle'S Landing

  • Specialist
  • Stockbridge, GA
  • NPI 1952518698

  GA

  Medicare reassignment Care Compare group NPD
• Rrsoc LLC

  • Body Imaging Physician
  • Columbus, GA
  • NPI 1295445237
  NPD (past)
• Women'S Health Specialists 2 LLC

  • Obstetrics & Gynecology Physician
  • Stockbridge, GA
  • NPI 1801926506

  Obstetrics & Gynecology

  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083633101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 EAGLES LANDING PKWY",
            "address_2": "#302",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-474-0064",
            "fax_number": "770-474-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 EAGLES LANDING PKWY",
            "address_2": "#302",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "30281",
            "telephone_number": "770-474-0064",
            "fax_number": "770-474-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "KIMBERLY",
        "middle_name": "JAYE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "053808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynesha McElveen
• Katherine Ann McFarlin, DO
• Jeffery Ray McGee, PA-C, AA-C
• Kavin K McGee
• Chanea McGhaney-Isom, RN
• Henry Lee McKay, MD
• Rachel Ayers McKay
• Denise McKinley
• McKinney Surgical Services
• Jackey S McKinney, LCSW

• All providers in Stockbridge, GA
• Obstetrics & Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.