Active NPI
Kimberly A Conner-Chatman, PA-C
- Physician Assistant
- Warner Robins, GA
National Provider Identifier
1295754653
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 002624
- Practice address
- 644 Tallulah TRL
Warner Robins, GA 31088-7625 - Phone
- (478) 328-2600
- Fax
- (478) 923-0055
- NPI assigned
- Jul 18, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 002624 | GA | Primary |
Addresses
Primary practice location
644 Tallulah TRL
Warner Robins, GA 31088-7625
Mailing address
644 Tallulah TRL
Warner Robins, GA 31088-7625
Phone (478) 328-2600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002624 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Healthcare Center, P.C. | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physician Assistant
- Warner Robins, GA
- NPI 1477666782
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295754653",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "644 TALLULAH TRL",
"city": "WARNER ROBINS",
"state": "GA",
"postal_code": "310887625",
"telephone_number": "478-328-2600",
"fax_number": "478-923-0055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "644 TALLULAH TRL",
"city": "WARNER ROBINS",
"state": "GA",
"postal_code": "310887625",
"telephone_number": "478-328-2600",
"fax_number": "478-923-0055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNER-CHATMAN",
"first_name": "KIMBERLY",
"middle_name": "A",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "002624",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Warner Robins, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.