Individual provider Active NPI

Kimyra Renae Milhouse, DO

  • Obstetrics & Gynecology Physician
  • Marietta, GA
National Provider Identifier
1588227664
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
95766 Issued in GA
Practice address
833 Campbl HL St NW Ste 400
Marietta, GA 30060-1147
Phone
(770) 528-0260
Fax
(770) 528-0269
NPI assigned
Apr 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Obstetrics & Gynecology Physician 207V00000X 95766 GA Primary

Addresses

Primary practice location

833 Campbl HL St NW Ste 400
Marietta, GA 30060-1147

Mailing address

833 Campbl HL St NW Ste 400
Marietta, GA 30060-1147
Phone (770) 528-0260

Other practice location 1

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (850) 418-3459

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kmilhouse289725@direct.vidanthealth.com
Direct Messaging Address kmilhouse526968@directwellstar.org

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
I20230721001120 GA Practitioner - Obstetrics/Gynecology 7214261551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Alabama College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

14025 Hwy 92
Suite 105
Woodstock, GA 30188-7138
Phone (678) 293-7854

14205 Hwy 92
Woodstock, GA 30188-7138

3747 Roswell Rd
Marietta, GA 30062-6227

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

833 Campbell Hill N W St
Suite 400
Marietta, GA 30060-1147
Phone (770) 528-0260

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
95766GAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Jul 15, 2023 Accepting new patients
Kennestone Hospital, Inc. Past Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Interoperability endpoints

  • Direct secure messaging: kmilhouse289725@direct.vidanthealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1588227664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CAMPBL HL ST NW STE 400",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601147",
            "telephone_number": "770-528-0260",
            "fax_number": "770-528-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 CAMPBL HL ST NW STE 400",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601147",
            "telephone_number": "770-528-0260",
            "fax_number": "770-528-0269"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Stantonsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278342818",
            "country_code": "US",
            "telephone_number": "850-418-3459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILHOUSE",
        "first_name": "KIMYRA",
        "middle_name": "RENAE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2023-09-06",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "95766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmilhouse289725@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmilhouse526968@directwellstar.org",
            "affiliation": "N",
            "address_1": "833 Campbl Hl St NW Ste 400",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300601147",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.