Kimberly Miller Connally, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5065 Issued in GA

Practice address

1150 Brookstone Centre Pkwy
Columbus, GA 31904-4577

Phone

(706) 257-4189

Fax

(706) 257-4194

NPI assigned

Jun 5, 2007

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

Other names 1

• Ms. Kimberly Miller Parker Former name

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Douglas Dermatology and Skin Cancer Specialists LLCGroup PAC ID 1658680764, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kimberly.parker@gadirect.net
• Direct secure messaging: kimberly.parker@sfhga.gadirect.net

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.

• Douglas Dermatology and Skin Cancer Specialists LLC

  • Dermatology Physician
  • Douglasville, GA
  • NPI 1275929267
  Medicare reassignment Care Compare group
• Aqua Dermatology of Georgia PC

  • Dermatology Physician
  • Marietta, GA
  • NPI 1114022167
  Medicare reassignment
• Dermatopathology Lab of Skin Cancer Specialists, P.C.

  • Clinical Medical Laboratory
  • Marietta, GA
  • NPI 1083044465
  NPD
• St Francis Columbus Clinic LLC

  • Family Medicine Physician
  • Columbus, GA
  • NPI 1295159143

  Physician Assistant

  NPD
• Gwinnett Dermatology PC D/B/a Georgia Dermatology Partners

  • Dermatology Physician
  • Snellville, GA
  • NPI 1477596203
  NPD (past)
• Mac-Lumpkin Rd LLC

  • Clinic/Center
  • Columbus, GA
  • NPI 1871894246
  NPD (past)

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647993600000",
    "number": "1487856092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 BROOKSTONE CENTRE PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319044577",
            "telephone_number": "706-257-4189",
            "fax_number": "706-257-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 BROOKSTONE CENTRE PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319044577",
            "telephone_number": "706-257-4189",
            "fax_number": "706-257-4194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNALLY",
        "first_name": "KIMBERLY",
        "middle_name": "MILLER",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "1561",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "5065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "PARKER",
            "middle_name": "MILLER",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Concierge Medicine of Columbus, Inc
• Nichole Cone, MS
• Terry Arthur Cone, M.D.
• Deborah Tillery Conkle, R.PH.
• Richard Neal Conkle
• Veronica Connard-Austin
• Ciera Connell
• John Coleman Connelly, MD
• Leigh Conner, PHARMD
• Lillian Conner

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; 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.