Individual provider Active NPI

Kristin A Waters, AAC

  • Anesthesiologist Assistant
  • Gainesville, GA
National Provider Identifier
1265767370
Registry record updated Oct 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
005622 Issued in GA
Practice address
743 Spring St NE
Gainesville, GA 30501-3715
Phone
(770) 532-7179
Fax
(770) 534-1312
NPI assigned
Oct 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X 005622 GA Primary

Addresses

Primary practice location

743 Spring St NE
Gainesville, GA 30501-3715

Mailing address

PO Box 1076
Gainesville, GA 30503-1076
Phone (770) 532-7179

Other practice location 1

146 Bill Carruth Pkwy
Hiram, GA 30141-3749
Phone (770) 794-0477

Other practice location 2

677 Church St NE
Marietta, GA 30060-1101
Phone (770) 794-0477

Other practice location 3

8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (770) 794-0477

Other practice location 4

2540 Windy Hill Rd SE
Marietta, GA 30067-8605
Phone (770) 794-0477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091026000481 GA Practitioner - Anesthesiology Assistant 7618014598 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Emory University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Anesthesia Professionals, LLCGroup PAC ID 5496134348, 543 clinicians
Anesthesia Associates of Gainesville, LLCGroup PAC ID 2769381771, 149 clinicians

Practice addresses (Care Compare)

1000 Medical Ctr Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-1000

743 Spring St NE
Gainesville, GA 30501-3715
Phone (770) 532-7179

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts, Physician Assistant

State licenses

LicenseStateTypeSpecialty
1893GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ambulatory Anesthesia of North Georgia, LLC CurrentSince Aug 18, 2009 Accepting new patients
Mak Anesthesia Holdings LLC CurrentSince Jul 1, 2021 Accepting new patients
Mak Anesthesia Georgia, LLC CurrentSince Aug 1, 2021 Accepting new patients
North Atlanta Anesthesia Professionals, LLC CurrentSince Apr 21, 2025 Accepting new patients
Capitol Anesthesiology, PC CurrentSince Aug 1, 2015 Accepting new patients
Anesthesia Associates of Gainesville, LLC CurrentSince Aug 18, 2009 Accepting new patients

Locations

365 E Paces Ferry Rd NE
Atlanta, GA 30305
Phone (404) 814-0868

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1400 River Pl
Braselton, GA 30517
Phone (770) 219-6000

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

1488 Jesse Jewell Pkwy SE
Ste 201
Gainesville, GA 30501
Phone (678) 253-0175

1488 Jesse Jewell Pkwy SE
Ste 100
Gainesville, GA 30501

1000 Medical Center Blvd
Lawrenceville, GA 30046
Phone (678) 312-3356

677 Church St NE
Marietta, GA 30060
Phone (770) 793-5435

1000 Corporate Center Dr
Ste 180
Morrow, GA 30260
Phone (770) 968-8888

5995 Barfield Rd
Sandy Springs, GA 30328
Phone (404) 256-1507

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

2131 Fountain Dr
Snellville, GA 30078
Phone (770) 736-2225

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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": "1254873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634169600000",
    "number": "1265767370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1076",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305031076",
            "telephone_number": "770-532-7179",
            "fax_number": "770-534-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-532-7179",
            "fax_number": "770-534-1312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "146 Bill Carruth Pkwy",
            "address_purpose": "LOCATION",
            "city": "Hiram",
            "state": "GA",
            "postal_code": "301413749",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "677 Church St NE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300601101",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8954 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Douglasville",
            "state": "GA",
            "postal_code": "301342272",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2540 Windy Hill Rd SE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300678605",
            "country_code": "US",
            "telephone_number": "770-794-0477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATERS",
        "first_name": "KRISTIN",
        "middle_name": "A",
        "credential": "AAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-07",
        "last_updated": "2021-10-14",
        "certification_date": "2021-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "005622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.