Katie Bodycomb Covington, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

003796 Issued in GA

Practice address

100 Stoneforest Dr Ste 320
Woodstock, GA 30189-4881

Phone

(770) 516-5199

Fax

(678) 213-1851

NPI assigned

Jun 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

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

Specialty

Physician Assistant

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlanta North Dermatology and Skin Care, Inc.Group PAC ID 0648346726, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Atlanta North Dermatology & Skin Care, Inc.

  • Dermatology Physician
  • Woodstock, GA
  • NPI 1215191085
  Medicare reassignment Care Compare group
• Aylo Health, LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1013018811
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Ellenwood, GA
  • NPI 1447290218
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Locust Grove, GA
  • NPI 1710929914
  NPD (past)
• Aylo Health, LLC

  • Sleep Medicine (Family Medicine) Physician
  • Stockbridge, GA
  • NPI 1922831445
  NPD (past)
• Parkway Anesthesia Consultants, PC

  • Certified Registered Nurse Anesthetist
  • Villa Rica, GA
  • NPI 1194887455
  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1407893217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 STONEFOREST DR STE 320",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301894881",
            "telephone_number": "770-516-5199",
            "fax_number": "678-213-1851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 STONEFOREST DR STE 320",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301894881",
            "telephone_number": "770-516-5199",
            "fax_number": "678-213-1851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVINGTON",
        "first_name": "KATIE",
        "middle_name": "BODYCOMB",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "003796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Costco Wholesale Corporation
• Costco Wholesale Corporation
• Rhana Liberty Coultas, OT
• Charles Oakley Coulter, DDS
• John Mark Covington Jr., DDS
• Hellana Cox, MSMFT
• Jerry Wayne Cox
• Tanaluk Pratheepratana Cox
• CP Specialized Services LLC
• Bonnie Petrie Craemer, L.C.S.W

• Medical Physician Assistant in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.