Individual provider Active NPI

Marilyn Wilson Kitchens, P.A.

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1306869904
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1050341 Issued in GA
Practice address
5673 Peachtree Dunwoody Rd NE
Suite 420
Atlanta, GA 30342-1731
Phone
(404) 255-4347
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 1050341 GA Primary

Addresses

Primary practice location

5673 Peachtree Dunwoody Rd NE
Suite 420
Atlanta, GA 30342-1731

Mailing address

44 King Arthur CT
Dallas, GA 30157-5934
Phone (404) 255-4347

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

LicenseStateTypeSpecialty
003736GAMDPhysical Therapist
1050341GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vainer & Vainer Nephrology Consultants, Inc PastSince Aug 3, 2021 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.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306869904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 KING ARTHUR CT",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301575934",
            "telephone_number": "404-255-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5673 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 420",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421731",
            "telephone_number": "404-255-4347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITCHENS",
        "first_name": "MARILYN",
        "middle_name": "WILSON",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "1050341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, 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.

Verify at the official NPI Registry.