NPIMap

Individual provider Active NPI

Kymberly M Tart, PA-C

  • Medical Physician Assistant
  • Dillon, MT
National Provider Identifier
1154530756
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
004137 Issued in GA
Practice address
600 Mt Highway 91 S
Dillon, MT 59725-7379
Phone
(406) 683-3000
NPI assigned
May 21, 2007
Last updated
Oct 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 004137 GA Primary

Addresses

Primary practice location

600 Mt Highway 91 S
Dillon, MT 59725-7379

Mailing address

601 S. Enota Drive
Suite Q
Gainesville, GA 30501
Phone (770) 533-8420

Other practice location 1

743 Spring St.
Gainesville, GA 30501
Phone (770) 535-3553

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address KTART750220@WM.PROVIDENCEDIRECT.ORG

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080208000133 GA Practitioner - Physician Assistant 4183707508 Reassigns benefits to 1 organization
I20170323001126 MT Practitioner - Physician Assistant 4183707508 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Barrett Hospital Development CorporationGroup PAC ID 4082904487, shared by 4 NPIs, 30 clinicians

Practice addresses (Care Compare)

30 Mt Hwy 91 S
Dillon, MT 59725-3535
Phone (406) 683-1188

600 Mt Hwy 91 S
Dillon, MT 59725-7379
Phone (406) 683-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004137GAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Barrett Hospital Development Corporation CurrentSince Feb 5, 2017 Accepting new patients
Barrett Hospital Development Corporation CurrentSince Jan 1, 2026 Accepting new patients
Barrett Hospital Development Corporation CurrentSince Feb 5, 2017 Accepting new patients
Northeast Georgia Physicians Group Inc CurrentSince Jan 1, 2009 Accepting new patients
Gainesville Heart and Vascular Group PC Past Accepting new patients

Locations

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

30 MT Highway 91 S
Dillon, MT 59725
Phone (406) 414-5070

600 MT Highway 91 S
Dillon, MT 59725
Phone (406) 683-3001

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/7421/brand/1/csg/1/fhir/r4
  • Direct secure messaging: ktart750220@wm.providencedirect.org

Organizations & group practices 5

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.

Hospital & facility affiliations 4

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1154530756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S. ENOTA DRIVE",
            "address_2": "SUITE Q",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "770-533-8420",
            "fax_number": "770-533-8440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MT HIGHWAY 91 S",
            "city": "DILLON",
            "state": "MT",
            "postal_code": "597257379",
            "telephone_number": "406-683-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "743 Spring St.",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "30501",
            "country_code": "US",
            "telephone_number": "770-535-3553",
            "fax_number": "770-533-8409",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TART",
        "first_name": "KYMBERLY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "004137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KTART750220@WM.PROVIDENCEDIRECT.ORG",
            "affiliation": "N",
            "address_1": "600 Mt Highway 91 S",
            "city": "Dillon",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597257379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dillon, MT

Sources for this page

Verify at the official NPI Registry.