Individual provider Active NPI

Mary-Kathryn Christine Wilkins, PA

  • Physician Assistant
  • Augusta, GA
National Provider Identifier
1790382711
Registry record updated Mar 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10038 Issued in GA
Practice address
820 St. Sebastian Way
Suite 1a
Augusta, GA 30901-2635
Phone
(706) 651-8400
Fax
(706) 651-8868
NPI assigned
Oct 2, 2020
Last updated
Mar 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10038 GA Primary

Addresses

Primary practice location

820 St. Sebastian Way
Suite 1a
Augusta, GA 30901-2635

Mailing address

820 St. Sebastian Way
Suite 1a
Augusta, GA 30901-2635
Phone (706) 651-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10038GAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1790382711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 ST. SEBASTIAN WAY",
            "address_2": "SUITE 1A",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012635",
            "telephone_number": "706-651-8400",
            "fax_number": "706-651-8868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 ST. SEBASTIAN WAY",
            "address_2": "SUITE 1A",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012635",
            "telephone_number": "706-651-8400",
            "fax_number": "706-651-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "MARY-KATHRYN",
        "middle_name": "CHRISTINE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "10038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; 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.