Individual provider Active NPI

Kristin Raye Harper, PA-C

  • Physician Assistant
  • Augusta, GA
National Provider Identifier
1306401328
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9390 Issued in GA
Practice address
1350 Walton Way
Augusta, GA 30901-2612
Phone
(706) 774-5795
Fax
(706) 774-5792
NPI assigned
May 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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 9390 GA Primary

Addresses

Primary practice location

1350 Walton Way
Augusta, GA 30901-2612

Mailing address

PO Box 1705
Augusta, GA 30903-1705
Phone (706) 854-6008

Other practice location 1

3001 Mercer University Dr
Atlanta, GA 30341-4115
Phone (678) 547-6305

Other practice location 2

1120 15th St
Augusta, GA 30912
Phone (706) 721-8623

Other practice location 3

1120 15th St
Augusta, GA 30912
Phone (706) 721-8623

Other practice location 4

2460 Washington Rd
Thomson, GA 30824-6600
Phone (706) 774-5795

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
I20191008004025 GA Practitioner - Physician Assistant 3870824642 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercer University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 604-1000

1350 Walton Way
Augusta, GA 30901-2612
Phone (706) 774-5995

Hospital & facility affiliations

  • Piedmont Augusta Hospital Hospital, Augusta, GA, CCN 110028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
9390GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Aug 8, 2019 Accepting new patients
Au Medical Associates Inc CurrentSince Aug 8, 2019 Accepting new patients

Locations

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

Organizations & group practices 3

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.

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": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1306401328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1705",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309031705",
            "telephone_number": "706-854-6008",
            "fax_number": "706-774-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012612",
            "telephone_number": "706-774-5795",
            "fax_number": "706-774-5792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3001 Mercer University Dr",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303414115",
            "country_code": "US",
            "telephone_number": "678-547-6305",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1120 15th St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "30912",
            "country_code": "US",
            "telephone_number": "706-721-8623",
            "fax_number": "706-721-1459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1120 15th St",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "30912",
            "country_code": "US",
            "telephone_number": "706-721-8623",
            "fax_number": "706-721-1459",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2460 Washington Rd",
            "address_purpose": "LOCATION",
            "city": "Thomson",
            "state": "GA",
            "postal_code": "308246600",
            "country_code": "US",
            "telephone_number": "706-774-5795",
            "fax_number": "706-774-5792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARPER",
        "first_name": "KRISTIN",
        "middle_name": "RAYE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.