Individual provider Active NPI

Kim Lee Capehart, DDS, PHD, MBA

  • General Practice Dentistry
  • Augusta, GA
National Provider Identifier
1568478907
Registry record updated Feb 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN015610 Issued in GA
Practice address
1430 John Wesley Gilbert Dr
Augusta, GA 30912-3234
Phone
(706) 721-4276
Fax
(706) 721-6778
NPI assigned
Jul 31, 2006
Last updated
Feb 19, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN015610 GA Primary

Addresses

Primary practice location

1430 John Wesley Gilbert Dr
Augusta, GA 30912-3234

Mailing address

1430 John Wesley Gilbert Drive
Augusta, GA 30912-0001
Phone (706) 721-2371

Other identifiers 2

IdentifierTypeStateIssuer
ZX3842MedicaidSC
003236054AMedicaidGA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210831000179 GA Practitioner - DentistPractitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 9133525140 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Au Medical Associates Inc CurrentSince Aug 1, 2021 Accepting new patients
Au Dental Associates CurrentSince Jun 26, 2023 Accepting new patients
Au Medical Associates Inc CurrentSince Aug 1, 2021 Accepting new patients
Au Surgery Center, LLC Past Accepting new patients

Locations

1120 15th St
Augusta, GA 30912
Phone (706) 721-3873

1120 15th St
Ste BI1056
Augusta, GA 30912
Phone (706) 721-2785

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771459200000",
    "number": "1568478907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 JOHN WESLEY GILBERT DRIVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120001",
            "telephone_number": "706-721-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 JOHN WESLEY GILBERT DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309123234",
            "telephone_number": "706-721-4276",
            "fax_number": "706-721-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPEHART",
        "first_name": "KIM",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS, PHD, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2026-02-19",
        "certification_date": "2026-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3842",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003236054A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.