Katelyn Victoria Brummett, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

13409 Issued in GA

Practice address

120 W Thigpen Ave
Lakeland, GA 31635-1011

Phone

(904) 742-3567

NPI assigned

Nov 8, 2019

Last updated

Aug 25, 2026By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1730724154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 GLYNN CIR",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316027222",
            "telephone_number": "865-393-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 W THIGPEN AVE",
            "city": "LAKELAND",
            "state": "GA",
            "postal_code": "316351011",
            "telephone_number": "904-742-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUMMETT",
        "first_name": "KATELYN",
        "middle_name": "VICTORIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-08",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9116231",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4114",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "13409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Blair
• Shelby T Bozeman, BCBA
• Joseph Clyde Brogdon, RPH
• Ann Brownell
• Bruce Herrington MD PC
• Burch Discount Drugs Inc (Burch Discount Drugs)
• Keona Bussey
• Eric A Castor, DMD
• Melanie Renee Christian, MSW
• Charles Coates II, PARAMEDIC

• Physician Assistant in Lakeland, GA
• Providers in Lakeland, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2026; 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.