Active NPI
Amy Kewin, MD
- Pediatrics Physician
- Marietta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 040118
- Practice address
- 760 Kennesaw Ave NW
Marietta, GA 30060-6909 - Phone
- (770) 427-0183
- Fax
- (770) 427-0788
- NPI assigned
- Oct 28, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 040118 | GA | Primary |
Addresses
Primary practice location
760 Kennesaw Ave NW
Marietta, GA 30060-6909
Mailing address
760 Kennesaw Ave NW
Marietta, GA 30060-6909
Phone (770) 427-0183
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Wellstar Kenmar Pediatrics, LLC | Pediatrics | Past | Accepting new patients |
Locations
4900 Ivey Rd NW
Ste 1326
Acworth, GA 30101
Phone (770) 427-0183
4550 Cobb Parkway North NW
Ste 302
Acworth, GA 30101
Phone (770) 427-0183
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230
760 Kennesaw Ave NW
Marietta, GA 30060
Phone (770) 427-0183
Interoperability endpoints
- akewin11217@directwellstar.org
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.
-
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
-
- Otolaryngology Physician
- Austell, GA
- NPI 1982900551
-
- Pediatrics Physician
- Marietta, GA
- NPI 1346296746
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408060800000",
"number": "1821088972",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "760 KENNESAW AVE NW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300606909",
"telephone_number": "770-427-0183",
"fax_number": "770-427-0788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 KENNESAW AVE NW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300606909",
"telephone_number": "770-427-0183",
"fax_number": "770-427-0788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEWIN",
"first_name": "AMY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-28",
"last_updated": "2014-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "040118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.