Katherine Tillem, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9345 Issued in GA

Practice address

8901 Stonebridge Blvd Ste 200
Douglasville, GA 30134-2254

Phone

(943) 202-7120

Fax

(470) 986-7087

NPI assigned

Aug 6, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Katherine Figella Former name

Electronic endpoints 1

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

Specialty

Physician Assistant

Education

Other, 2019

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)

Hospital & facility affiliations

• Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184

Merit-based Incentive Payment System (MIPS)

Final score

94.51 of 100Reported as apm

Quality

80.61

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment Care Compare group
• Peachtree Immediate Care FP, LLC

  • Family Medicine Physician
  • Hiram, GA
  • NPI 1437194156
  Medicare reassignment
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Medical Group, LLC

  dba WellStar Family Medicine (Governors)

  • Family Medicine Physician
  • Acworth, GA
  • NPI 1689077562

  Multi-Specialty

  NPD
• Wellstar Cardiovascular Medicine, LLC

  • Cardiovascular Disease Physician
  • Marietta, GA
  • NPI 1457320319

  Multi-Specialty

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Douglas Hospital, Inc.

  dba Wellstar Douglas Hospital

  • General Acute Care Hospital
  • Douglasville, GA
  • NPI 1649247974
  Care Compare affiliation

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

{
    "created_epoch": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715904000000",
    "number": "1780239889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 STONEBRIDGE BLVD STE 200",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342254",
            "telephone_number": "943-202-7120",
            "fax_number": "470-986-7087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8901 STONEBRIDGE BLVD STE 200",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342254",
            "telephone_number": "943-202-7120",
            "fax_number": "470-986-7087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEM",
        "first_name": "KATHERINE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ktillem541328@directwellstar.org",
            "affiliation": "N",
            "address_1": "8901 Stonebridge Blvd Ste 200",
            "city": "Douglasville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301342254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "FIGELLA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kay E Thompson, RN
• Anuradha R Thopu, MD
• Alison M. Thornton, N.P.
• Maurica Lamonte Thrower
• Joel Ray Tidwell, DDS
• Timothy N. Byrd, DMD & Associates of Douglasville, PC
• TL Smith Healthcare LLC
• TMC Total Care Family Medicine Inc
• Charkeshia Toatley, LPC
• Sean Todd-Crooks

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.