Nakato B. Kibuyaga-Travis, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

066960 Issued in GA

Practice address

6043 Prestley Mill Rd Ste B
Douglasville, GA 30134-2280

Phone

(770) 947-3000

NPI assigned

Jul 18, 2008

Last updated

Oct 10, 2019By the provider in NPPES

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

Electronic endpoints 1

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

Specialty

Family Practice

Education

Morehouse School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Qcpi-Villagemd PCGroup PAC ID 8123389277, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nakato.kibuyaga-travis.1@21533.direct.athenahealth.com
• Direct secure messaging: nkibuyagatravis429405@directwellstar.org

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.

• Qcpi-Villagemd, PC

  dba Village Medical

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1558872432
  Medicare reassignment Care Compare group
• Neighbormd of Atlanta LLC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1902407752
  Medicare reassignment NPD
• Neighbormd of South Atlanta LLC

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1285235036
  Medicare reassignment NPD
• Premier South Medical Group, P.C.

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1528114295
  Medicare reassignment NPD
• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956

  Family Medicine

  Medicare reassignment NPD
• Wellstreet of Georgia PC

  dba Piedmont Urgent Care

  • Urgent Care Clinic/Center
  • Newnan, GA
  • NPI 1235411547
  Medicare reassignment NPD
• Crosslinks Family Practice, LLC

  • Family Medicine Physician
  • Tucker, GA
  • NPI 1295131530
  NPD
• Advanced Internal Medicine

  • Primary Care Clinic/Center
  • Stockbridge, GA
  • NPI 1669658829
  NPD (past)
• JW Medical Care, LLC

  • Family Medicine Physician
  • College Park, GA
  • NPI 1730329806
  NPD (past)

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

• Fayette Community Hospital, Inc.

  dba Piedmont Fayette Hospital

  • General Acute Care Hospital
  • Fayetteville, GA
  • NPI 1528027240
  Care Compare affiliation

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1609031657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT ROAD, NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051736",
            "telephone_number": "404-364-7070",
            "fax_number": "678-336-7099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6043 PRESTLEY MILL RD STE B",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342280",
            "telephone_number": "770-947-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1175 Cascade Pkwy",
            "address_2": "Kaiser Permanente Cascade Medical",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "03311",
            "country_code": "US",
            "telephone_number": "404-365-0966",
            "fax_number": "404-768-8035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIBUYAGA-TRAVIS",
        "first_name": "NAKATO",
        "middle_name": "B.",
        "name_prefix": "Ms.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-18",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "003467",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "066960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nkibuyagatravis126772@directwellstar.org",
            "affiliation": "N",
            "address_1": "6043 Prestley Mill Rd Ste B",
            "city": "Douglasville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301342280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kira Kendall, BA ASSISTANT
• Rajeen Keys, PHARMD
• Ambreen Khalid, MD
• Madeeha Khan, M.D
• Saba Khan, M.D.
• Kidney Care Specialists LLC
• Kids of Grace, Inc.
• Kidz Rock Therapy Services, LLC
• Brenda A Kiger
• Kight & Camp's Transportation, LLC

• Family Medicine Physician in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.