Individual provider Active NPI

Kimberly Prater, FNP-C

  • Family Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1700288339
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN185543 Issued in GA
Practice address
745 Poplar Rd
Newnan, GA 30265-1618
Phone
(404) 605-2800
NPI assigned
Sep 26, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN185543 GA Primary

Addresses

Primary practice location

745 Poplar Rd
Newnan, GA 30265-1618

Mailing address

745 Poplar Rd
Newnan, GA 30265-1618
Phone (404) 605-2800

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150224000184 GA Practitioner - Nurse Practitioner 2466778188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

1267 Hwy 54 W
Suite 4100
Fayetteville, GA 30214-2112
Phone (770) 506-5470

1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone (770) 918-3000

5126 Hospital Dr NE
Covington, GA 30014-2566
Phone (770) 786-7053

745 Poplar Rd
Newnan, GA 30265-1618
Phone (770) 253-1912

Hospital & facility affiliations

  • Piedmont Newnan Hospital, Inc Hospital, Newnan, GA, CCN 110229
  • Piedmont Fayette Hospital Hospital, Fayetteville, GA, CCN 110215
  • Piedmont Hospital, Inc Hospital, Atlanta, GA, CCN 110083

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Cardiology of Atlanta, LLC CurrentSince Mar 27, 2017 Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1700288339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 POPLAR RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651618",
            "telephone_number": "404-605-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 POPLAR RD",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651618",
            "telephone_number": "404-605-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATER",
        "first_name": "KIMBERLY",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN185543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.