Individual provider Active NPI

Kimberly Nicole Works, M.D.

  • Pediatrics Physician
  • Tifton, GA
National Provider Identifier
1285992073
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
073674 Issued in GA
Practice address
39 Kent Rd
Suite 5
Tifton, GA 31794-1698
Phone
(229) 353-7337
NPI assigned
Apr 30, 2012
Last updated
Feb 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NJ
Pediatrics Physician 208000000X 073674 GA Primary

Addresses

Primary practice location

39 Kent Rd
Suite 5
Tifton, GA 31794-1698

Mailing address

6065 Lake Forrest Dr Ste 250
Atlanta, GA 30328-3868
Phone (404) 301-2191

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151201000521 GA Practitioner - Pediatric Medicine 9830499623 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
073674GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Georgia PC CurrentSince May 3, 2024 Accepting new patients
Pediatric Works CurrentSince Mar 5, 2023 Accepting new patients
Douglas Hospital, Inc. Past Accepting new patients
Vidalia Health Services, LLC Past Accepting new patients

Locations

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

6065 Lake Forrest Dr
Ste 250
Sandy Springs, GA 30328
Phone (404) 301-2191

1 Meadows Pkwy
Vidalia, GA 30474
Phone (912) 535-5429

120 Brentwood Commons Way
Ste 510
Brentwood, TN 37027
Phone (253) 682-6040

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1285992073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6065 LAKE FORREST DR STE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303283868",
            "telephone_number": "404-301-2191",
            "fax_number": "404-301-4177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 KENT RD",
            "address_2": "SUITE 5",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317941698",
            "telephone_number": "229-353-7337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORKS",
        "first_name": "KIMBERLY",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "073674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

Verify at the official NPI Registry.