Kimberly Brooke Mathis, WHNP-BC

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

RN197036 Issued in GA

Practice address

140 Eagle Spring CT
Stockbridge, GA 30281-6441

Phone

(770) 302-0878

NPI assigned

Apr 10, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12492/brand/1/csg/1/fhir/r4

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.

• The Womens Center PC

  • Gynecology Physician
  • Conyers, GA
  • NPI 1871654624
  NPD (past)
• Cny Fertility Center

  • Reproductive Endocrinology Physician
  • Syracuse, NY
  • NPI 1568504298
  NPD (past)

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

{
    "created_epoch": "1491782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491782400000",
    "number": "1821521477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 EAGLE SPRING CT",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816441",
            "telephone_number": "770-302-0878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 EAGLE SPRING CT",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816441",
            "telephone_number": "770-302-0878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATHIS",
        "first_name": "KIMBERLY",
        "middle_name": "BROOKE",
        "credential": "WHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-10",
        "last_updated": "2017-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN197036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Mason
• Alexandria Massey, PT, DPT
• Mastin 4 You Staffing & Health Services LLC
• Sushila M Mathew, MD
• Chianti Mathis, M.A. SLP
• Vernette R Mathurin, LPN
• Matrix Rehabilitation-Georgia Inc
• Gary Eugene Matthews, MD
• Catherine T Mauer, MD
• Maxcare Medical Center, LLC

• Women's Health Nurse Practitioner in Stockbridge, GA
• Providers in Stockbridge, GA by specialty
• Women's Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2017; 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.

Verify at the official NPI Registry.