Individual provider Active NPI

Timothy Richard Kinsey Jr., M.D.

  • Pediatrics Physician
  • Waynesboro, GA
National Provider Identifier
1669476586
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101235162 Issued in GA
Practice address
305 Jones Ave
Waynesboro, GA 30830-1510
Phone
(706) 554-5147
Fax
(706) 437-2228
NPI assigned
Jun 9, 2005
Last updated
Jul 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101235162 GA Primary

Addresses

Primary practice location

305 Jones Ave
Waynesboro, GA 30830-1510

Mailing address

305 Jones Ave
Waynesboro, GA 30830-1510
Phone (706) 554-5147

Other identifiers 2

IdentifierTypeStateIssuer
58-1308396MedicaidGA
010007208MedicaidVA

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
I20060929000488 GA Practitioner - Pediatric Medicine 9234033499

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical SpecialistsGroup PAC ID 0840108478, shared by 2 NPIs, 9 clinicians

Practice addresses (Care Compare)

305 Jones Ave
Waynesboro, GA 30830-1510

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101235162VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Specialists CurrentSince Feb 22, 2013 Accepting new patients
Medical Specialists, Inc CurrentSince Feb 22, 2013 Accepting new patients

Locations

305 Jones Ave
Waynesboro, GA 30830
Phone (706) 554-5147

406 E Broad St
Wrens, GA 30833
Phone (706) 547-7008

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
North Jefferson Medical CenterWrens, GA, CCN 113882 Rural health clinic 5% Or Greater Direct Ownership Interest (16.67%) Jan 1, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 2

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1669476586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 JONES AVE",
            "city": "WAYNESBORO",
            "state": "GA",
            "postal_code": "308301510",
            "telephone_number": "706-554-5147",
            "fax_number": "706-437-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 JONES AVE",
            "city": "WAYNESBORO",
            "state": "GA",
            "postal_code": "308301510",
            "telephone_number": "706-554-5147",
            "fax_number": "706-437-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINSEY",
        "first_name": "TIMOTHY",
        "middle_name": "RICHARD",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "0101235162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58-1308396",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010007208",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, GA

Sources for this page

Verify at the official NPI Registry.