Sophia Grace Killett, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

4286 Issued in TN

Practice address

1622 Westgate Cir
Brentwood, TN 37027-8019

Phone

(629) 255-2277

Fax

(629) 255-4258

NPI assigned

Nov 3, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Heritage Medical Associates PCGroup PAC ID 4688651037, 162 clinicians

Select Physical Therapy Holdings IncGroup PAC ID 9537076401, shared by 76 NPIs, 1,992 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sophiakillett@hma.allscriptsdirect.net

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.

• Heritage Medical Associates PC

  • Internal Medicine Physician
  • Nashville, TN
  • NPI 1548284060
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1285235648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 22ND AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031852",
            "telephone_number": "629-255-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 WESTGATE CIR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370278019",
            "telephone_number": "629-255-2277",
            "fax_number": "629-255-4258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 22nd Ave N",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372031852",
            "country_code": "US",
            "telephone_number": "629-255-2277",
            "fax_number": "629-255-4258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLETT",
        "first_name": "SOPHIA",
        "middle_name": "GRACE",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-03",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "4286",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q076744",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nassour Kheir
• Jamshid Khoshnoodi, PHD, LCSW
• Kidd Senior Care Service, Inc.
• Lana Kidd, D PH
• David Kies
• Shayna Rose Killian
• Ashley Kimball
• Owen Kimbrel
• Kimmy'S Cottage, Inc.
• Abigail King, CCC-SLP

• Physician Assistant in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.