Kristin Bost Gaffney, PA-C, MSPAS

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

7932 Issued in GA

Practice address

3707 Largent Way NW
Marietta, GA 30064

Phone

(678) 581-5729

Fax

(678) 581-5719

NPI assigned

Sep 16, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1316131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572998400000",
    "number": "1457633307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SANDY PLAINS ROAD",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 LARGENT WAY NW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30064",
            "telephone_number": "678-581-5729",
            "fax_number": "678-581-5719"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4645 Augusta Rd",
            "address_purpose": "LOCATION",
            "city": "Beech Island",
            "state": "SC",
            "postal_code": "298427265",
            "country_code": "US",
            "telephone_number": "803-593-9283",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4645 Augusta Rd",
            "address_purpose": "LOCATION",
            "city": "Beech Island",
            "state": "SC",
            "postal_code": "298427265",
            "country_code": "US",
            "telephone_number": "803-593-9283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAFFNEY",
        "first_name": "KRISTIN",
        "middle_name": "BOST",
        "credential": "PA-C, MSPAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-16",
        "last_updated": "2019-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-04394",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "1715",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "7932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1742PA",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457633307",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kgaffney142549@directwellstar.org",
            "affiliation": "N",
            "address_1": "3707 Largent Way NW",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300645981",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Medical Physician Assistant in Marietta, GA
• Providers in Marietta, 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 Nov 6, 2019; 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.