Individual provider Active NPI

Kate Hallie Baskin

  • Physician Assistant
  • Peachtree City, GA
National Provider Identifier
1295458305
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
112 Wilshire Village Dr
Peachtree City, GA 30269-3138
Phone
(770) 676-3376
NPI assigned
Sep 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

112 Wilshire Village Dr
Peachtree City, GA 30269-3138

Mailing address

112 Wilshire Village Dr
Peachtree City, GA 30269-3138
Phone (770) 676-3376

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240711000354 GA Practitioner - Physician Assistant 0749725059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
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)

354 Newnan Crossing Byp
Suite 205
Newnan, GA 30265-2434
Phone (770) 520-8561

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12146GAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
West Georgia Derm Surgery Center Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1295458305",
    "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": "BASKIN",
        "first_name": "KATE",
        "middle_name": "HALLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-22",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

Sources for this page

Verify at the official NPI Registry.