Individual provider Active NPI

Kimberly Michelle Diprima, PA-C

  • Physician Assistant
  • Fayetteville, GA
National Provider Identifier
1366854077
Registry record updated Jun 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
007226 Issued in GA
Practice address
1265 Highway 54 W
Suite 102
Fayetteville, GA 30214-4548
Phone
(770) 460-1900
Fax
(770) 719-1214
NPI assigned
May 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2016

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 007226 GA Primary

Addresses

Primary practice location

1265 Highway 54 W
Suite 102
Fayetteville, GA 30214-4548

Mailing address

900 Circle 75 Pkwy SE
Suite 1700
Atlanta, GA 30339-3035
Phone (770) 953-6929

Other names 1

  • Kimberly Michelle Kennedy Former name

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
I20140818001549 GA Practitioner - Physician Assistant 9638396534 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Mercer University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Orthopedics, LLCGroup PAC ID 4385963172, 191 clinicians

Practice addresses (Care Compare)

1968 Peachtree Rd NW
Atlanta, GA 30309-1281
Phone (404) 352-1053

620 Cherokee St NE
Suite 300
Marietta, GA 30060-7202
Phone (770) 635-1812

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoatlanta, LLC CurrentSince Jun 19, 2014 Accepting new patients
Orthoatlanta, LLC Physician Assistant CurrentSince Jun 19, 2014 Accepting new patients
Orthoatlanta, LLC Past Accepting new patients
Orthoatlanta, LLC Past Accepting new patients

Locations

105 Collier Rd NW
Ste 2000
Atlanta, GA 30309
Phone (404) 350-1122

1800 Howell Mill Rd NW
Ste 200
Atlanta, GA 30318
Phone (404) 352-1015

900 Circle 75 Pkwy SE
Ste 1700
Atlanta, GA 30339
Phone (770) 953-6929

1265 Highway 54 W
Ste 308
Fayetteville, GA 30214
Phone (678) 216-0771

1265 Highway 54 W
Ste 102
Fayetteville, GA 30214
Phone (770) 460-1900

1265 Highway 54 W
Ste 200
Fayetteville, GA 30214
Phone (404) 785-8785

620 Cherokee St NE
Ste 300
Marietta, GA 30060
Phone (770) 635-1812

1240 Eagles Landing Pkwy
Ste 300
Stockbridge, GA 30281
Phone (770) 506-4350

Organizations & group practices 6

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": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465430400000",
    "number": "1366854077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CIRCLE 75 PKWY SE",
            "address_2": "SUITE 1700",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393035",
            "telephone_number": "770-953-6929",
            "fax_number": "770-953-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 HIGHWAY 54 W",
            "address_2": "SUITE 102",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144548",
            "telephone_number": "770-460-1900",
            "fax_number": "770-719-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIPRIMA",
        "first_name": "KIMBERLY",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2016-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "007226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "KENNEDY",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.