Kimberly Michelle Wahler, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

004784 Issued in GA

Practice address

5505 Peachtree Dunwoody Rd NE
Ste. 410
Atlanta, GA 30342-1705

Phone

(404) 250-3333

Fax

(404) 250-0175

NPI assigned

May 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Fung Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Carmen M Kavali MD PC

  • Plastic Surgery Physician
  • Atlanta, GA
  • NPI 1538343884
  NPD (past)

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1366409583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "183 3RD AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303172705",
            "telephone_number": "813-409-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 PEACHTREE DUNWOODY RD NE",
            "address_2": "STE. 410",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421705",
            "telephone_number": "404-250-3333",
            "fax_number": "404-250-0175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHLER",
        "first_name": "KIMBERLY",
        "middle_name": "MICHELLE",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-01",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "004784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "FUNG",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William Van Wagstaff
• Peter Philobateer Wahba, MD
• Nida Waheed
• Sana Waheed, M.D.
• Madison Wahl
• Jacqueline Waice, DC, ATC
• Joseph Waiguru
• Bruce H. Wainer, M.D., PH.D.
• Ashley Farrell Wainio, ANES. ASST.
• Cari Wainio

• Surgical Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.