Kelly O'Keefe-Watson, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5849 Issued in GA

Practice address

512 S Main St
Hinesville, GA 31313-4325

Phone

(912) 369-5437

NPI assigned

Jul 5, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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

Emory University School of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pain Treatment Centers of Georgia LLCGroup PAC ID 7012302425, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Pain Treatment Centers of Georgia LLC

  • Clinic/Center
  • Hinesville, GA
  • NPI 1548931249

  GA

  Medicare reassignment Care Compare group NPD
• Southern Allergy and Asthma PC

  • Allergy & Immunology Physician
  • Savannah, GA
  • NPI 1467547281

  GA

  Medicare reassignment
• St. Francis Physician Practices LLC

  • Family Medicine Physician
  • Columbus, GA
  • NPI 1326749417

  GA

  Medicare reassignment
• Pain Treatment Centers of Georgia LLC

  • Pain Clinic/Center
  • Richmond Hill, GA
  • NPI 1134909542
  Care Compare group
• Pain Treatment Centers of Georgia LLC

  • Clinic/Center
  • Savannah, GA
  • NPI 1619702792
  Care Compare group
• St Francis Physician Practices LLC

  • Internal Medicine Physician
  • Columbus, GA
  • NPI 1780059121
  NPD
• St. Francis Physician Practices LLC

  • Gastroenterology Physician
  • Columbus, GA
  • NPI 1609655646
  NPD
• Pain Treatment Centers of Georgia LLC

  • Pain Medicine Physician
  • Swainsboro, GA
  • NPI 1568327211
  NPD (past)
• St Francis Physician Practices LLC

  • Clinical Cardiac Electrophysiology Physician
  • Columbus, GA
  • NPI 1982079323
  NPD (past)

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

{
    "created_epoch": "1278288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1174835334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 S MAIN ST",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 S MAIN ST",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134325",
            "telephone_number": "912-369-5437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'KEEFE-WATSON",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-05",
        "last_updated": "2022-04-07",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AL",
            "license": "PA.712",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "5849",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "20297I6144",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003105013",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170095",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Ilene Numkena
• David M. Nussbaum, D. O.
• Elaine Nussbaum, APN
• Bethany Olivia O'Bryan
• T'Challa O'Bryant, LPC
• Christopher O'Malley, PTA
• Jada O'Neal
• Occeus Holistic Care, LLC
• Occupational Health Centers of Georgia PC
• Occupational Health Centers of Georgia PC

• All providers in Hinesville, GA
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.