Individual provider Active NPI

Kelly D Howard, AA

  • Anesthesiologist Assistant
  • Savannah, GA
National Provider Identifier
1275635393
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
004890 Issued in GA
Practice address
400 Mall Blvd
Suite T
Savannah, GA 31406-4861
Phone
(912) 355-7214
Fax
(517) 787-7365
NPI assigned
Sep 1, 2006
Last updated
Feb 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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 004890 GA Primary

Addresses

Primary practice location

400 Mall Blvd
Suite T
Savannah, GA 31406-4861

Mailing address

804 Scott Nixon Memorial Dr
Augusta, GA 30907-2464
Phone (706) 650-0705

Other names 1

  • Kelly D Wade Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061205000428 GA Practitioner - Anesthesiology Assistant 7214936046 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Anesthesiology Associates of Georgia LLCGroup PAC ID 7618934779, 230 clinicians

Practice addresses (Care Compare)

2701 N Decatur Rd
Decatur, GA 30033-5918
Phone (678) 514-1991

5353 Reynolds St
Savannah, GA 31405-6015
Phone (912) 819-6000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Specialists in Anesthesia, P.C. Anesthesiologist Assistant CurrentSince Sep 15, 2006 Accepting new patients
American Anesthesiology Associates of Georgia, LLC CurrentSince Mar 16, 2016 Accepting new patients

Locations

2701 N Decatur Rd
Decatur, GA 30033
Phone (404) 501-1000

101 Saint Josephs Candler Dr
Pooler, GA 31322
Phone (912) 450-1945

247 S Main St
Reidsville, GA 30453
Phone (912) 557-1207

5671 Ptree Dunwoody Rd NE
Ste 800
Sandy Springs, GA 30342
Phone (404) 257-1415

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

11909 McAuley Dr
Ste B
Savannah, GA 31419
Phone (912) 819-2237

210 E Derenne Ave
Savannah, GA 31405
Phone (912) 355-0140

5353 Reynolds St
Savannah, GA 31405
Phone (912) 692-6172

Organizations & group practices 2

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 1

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1275635393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SCOTT NIXON MEMORIAL DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309072464",
            "telephone_number": "706-650-0705",
            "fax_number": "706-650-1034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MALL BLVD",
            "address_2": "SUITE T",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064861",
            "telephone_number": "912-355-7214",
            "fax_number": "517-787-7365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "KELLY",
        "middle_name": "D",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "004890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "WADE",
            "middle_name": "D",
            "credential": "AA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; 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.