Active NPI
Elicia Ariel Parvin Kimsey, PA-C
- Physician Assistant
- Taylorsville, GA
National Provider Identifier
1184951600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 005723
- Practice address
- 48 Hills Creek Rd
Taylorsville, GA 30178-2051 - Phone
- (770) 684-8700
- NPI assigned
- Nov 4, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 005723 | GA | Primary |
Addresses
Primary practice location
48 Hills Creek Rd
Taylorsville, GA 30178-2051
Mailing address
420 E 2ND Ave Ste 103
Rome, GA 30161-3210
Phone (706) 509-3000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 551689539A | Medicaid | GA | |
| 551689539B | Medicaid | GA | |
| 551689539C | Medicaid | GA |
Other names 1
- Elicia Ariel Parvin
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100129000030 | GA | Practitioner - Physician Assistant | 5890837868 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623715200000",
"number": "1184951600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "420 E 2ND AVE STE 103",
"city": "ROME",
"state": "GA",
"postal_code": "301613210",
"telephone_number": "706-509-3000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 HILLS CREEK RD",
"city": "TAYLORSVILLE",
"state": "GA",
"postal_code": "301782051",
"telephone_number": "770-684-8700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMSEY",
"first_name": "ELICIA",
"middle_name": "ARIEL PARVIN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-04",
"last_updated": "2021-06-15",
"certification_date": "2021-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "005723",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "551689539A",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "551689539B",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "551689539C",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ELICIA",
"last_name": "PARVIN",
"middle_name": "ARIEL",
"credential": "PA-C",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Taylorsville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.