Brian Patrick Kittrell, CST, CSFA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

213054 Issued in GA

Practice address

2537 Cedarcrest Rd Ste 305-14
Acworth, GA 30101-8900

Phone

(470) 336-8190

Fax

(770) 336-6620

NPI assigned

Jul 17, 2023

Last updated

Jul 17, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Oasis Surgical Assistants, LLC

  • Surgical Physician Assistant
  • Acworth, GA
  • NPI 1134622533
  NPD

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

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1609555630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2537 CEDARCREST RD STE 305-14",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301018900",
            "telephone_number": "470-336-8190",
            "fax_number": "770-336-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2537 CEDARCREST RD STE 305-14",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301018900",
            "telephone_number": "470-336-8190",
            "fax_number": "770-336-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTRELL",
        "first_name": "BRIAN",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "CST, CSFA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "213054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Kim, DO
• Eunice Kim
• Richard William Kimmerling, MD
• Cathy Lee King
• Beth Kise, LCSW
• Kara Klayman, MS CCC/SLP
• Rhonda L Knight
• Susan Rosemary Korey, PHARMD
• Tumu T Korlie
• Julia Kosatka

• Surgical Physician Assistant in Acworth, GA
• Providers in Acworth, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.