Johanna Kimberl, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11982 Issued in GA

Practice address

61 Whitcher St NE Ste 2100
Marietta, GA 30060-1179

Phone

(770) 423-0595

NPI assigned

Mar 25, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vascular Surgical Associates, PCGroup PAC ID 6709862212, 25 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vascular Surgical Associates, PC

  • Vascular Surgery Physician
  • Marietta, GA
  • NPI 1114083532
  Medicare reassignment Care Compare group NPD
• Vascular Surgical Associates, PC

  • Prosthetic/Orthotic Supplier
  • Austell, GA
  • NPI 1265921183
  NPD
• Vicksburg Hma Physician Management LLC

  • Internal Medicine Physician
  • Vicksburg, MS
  • NPI 1407020407
  NPD

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1477915718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE STE 2100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601179",
            "telephone_number": "770-423-0595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 WHITCHER ST NE STE 2100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601179",
            "telephone_number": "770-423-0595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMBERL",
        "first_name": "JOHANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-25",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "PA00285",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minje Kim, FNP
• Seonghyeon Kim, DDS
• Stephanie Kim
• Stephen Kim, M.D.
• Kay Ann Kimball, CNP
• Kimberly Wallace LPC LLC
• Candance Kimbrough-Green, M.D.
• Kimchang & Company, LLC (Post Oak Pediatric Dentistry)
• Kirk Andrew Kimmerling, D.D.S.
• Patricia White Kimmerling, D.D.S.

• Physician Assistant in Marietta, GA
• Providers in Marietta, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; 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.