Individual provider Active NPI

Katya Monet Brickman, MSN, CNM

  • Advanced Practice Midwife
  • Griffin, GA
National Provider Identifier
1770830408
Registry record updated Sep 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN256354 Issued in GA
Practice address
503 S 8TH St
Griffin, GA 30224-4211
Phone
(770) 227-5505
NPI assigned
Aug 13, 2012
Last updated
Sep 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 0205348 CO
Advanced Practice MidwifeGroup: 193400000X SINGLE SPECIALTY GROUP 367A00000X RN256354 GA Primary

Addresses

Primary practice location

503 S 8TH St
Griffin, GA 30224-4211

Mailing address

503 S 8TH St
Griffin, GA 30224-4211

Other practice location 1

1675 Garden Of The Gods Rd
Colorado Springs, CO 80907-9444
Phone (719) 578-3242

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180910001804 GA Practitioner - Certified Nurse Midwife (CNM) 0547510737 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Emory University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

601 S 8TH St
Griffin, GA 30224-4213
Phone (770) 228-2721

619 S 8TH St
Griffin, GA 30224-4260

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
0205348COMDRegistered Nurse
RN256354GAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Single Specialty CurrentSince Jan 1, 2025 Accepting new patients
Griffin OBGYN Clinic PA Single Specialty CurrentSince Jul 15, 2018 Accepting new patients
Wellstar Medical Group, LLC Single Specialty Current Accepting new patients

Locations

503 S 8th St
Griffin, GA 30224
Phone (770) 227-5505

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

403 W Main St
Thomaston, GA 30286
Phone (706) 646-2888

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13935/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662595200000",
    "number": "1770830408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244211",
            "telephone_number": "770-227-5505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1675 Garden Of The Gods Rd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809079444",
            "country_code": "US",
            "telephone_number": "719-578-3242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRICKMAN",
        "first_name": "KATYA",
        "middle_name": "MONET",
        "name_prefix": "Mrs.",
        "credential": "MSN, CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-13",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "0205348",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN256354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

Verify at the official NPI Registry.