Kathryn Anne O'Meara, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9320 Issued in GA

Practice address

112 Wilshire Village Dr
Peachtree City, GA 30269-3138

Phone

(770) 676-3376

NPI assigned

Jun 13, 2019

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

Electronic endpoints 2

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

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Specialists of W GaGroup PAC ID 1456397660, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dermatology Specialists of W Ga

  dba Newnan Dermatology

  • Dermatology Physician
  • Carrollton, GA
  • NPI 1780658203
  Medicare reassignment Care Compare group
• Skin Cancer and Cosmetic Dermatology Center PC

  • Dermatology Physician
  • Chattanooga, TN
  • NPI 1144419458
  NPD
• West Georgia Derm Surgery Center

  • MOHS-Micrographic Surgery Physician
  • Carrollton, GA
  • NPI 1235065590
  NPD (past)

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1235799198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 WILSHIRE VILLAGE DR",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693138",
            "telephone_number": "770-676-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 WILSHIRE VILLAGE DR",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693138",
            "telephone_number": "770-676-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MEARA",
        "first_name": "KATHRYN",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9320",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Alpharetta",
            "affiliation": "N",
            "address_1": "3400-C Old Milton Pkwy",
            "address_2": "#270",
            "city": "Alpharetta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jychung@directaddress.net",
            "affiliation": "Y",
            "affiliationName": "Skin Cancer & Cosmetic Dermatology Center, PC",
            "address_1": "1107 Memorial Drive",
            "address_2": "Suite 201",
            "city": "Dalton",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physician Assistant in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; 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.