Individual provider Active NPI

Katie Lyn Kurtz, PA-C

  • Medical Physician Assistant
  • Conyers, GA
National Provider Identifier
1124449723
Registry record updated Mar 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10945 Issued in GA
Practice address
2020 Honey Creek Pkwy SE
Conyers, GA 30013-2974
Phone
(770) 929-0813
Fax
(770) 922-8653
NPI assigned
Dec 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Respiratory Therapist 227900000X
Medical Physician Assistant 363AM0700X 10945 GA Primary

Addresses

Primary practice location

2020 Honey Creek Pkwy SE
Conyers, GA 30013-2974

Mailing address

2020 Honey Creek Pkwy SE
Conyers, GA 30013-2974
Phone (770) 929-0813

Other names 1

  • Katie Lyn Mauzy Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220427001089 GA Practitioner - Physician Assistant 5193112852

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Esop Rehabilitation LLCGroup PAC ID 9739305749, shared by 9 NPIs, 224 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

875 Flat Shoals Rd SE
Suite 150
Conyers, GA 30094-6640
Phone (770) 785-7669

9152 Hwy 278 NE
Covington, GA 30014-7010
Phone (678) 342-9339

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1388102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1124449723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 HONEY CREEK PKWY SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132974",
            "telephone_number": "770-929-0813",
            "fax_number": "770-922-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 HONEY CREEK PKWY SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300132974",
            "telephone_number": "770-929-0813",
            "fax_number": "770-922-8653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURTZ",
        "first_name": "KATIE",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-27",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227900000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "10945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATIE",
            "last_name": "MAUZY",
            "middle_name": "LYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.