Kathleen Elizabeth Empen, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

044454 Issued in GA

Practice address

51 Hiram Dr BLDG B
Hiram, GA 30141

Phone

(678) 945-8300

Fax

(770) 445-2060

NPI assigned

May 8, 2006

Last updated

Oct 16, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kempen21452@directwellstar.org

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.

• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

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

  dba WellStar Douglasville Medical Center

  • Internal Medicine Physician
  • Douglasville, GA
  • NPI 1386940922
  NPD
• Wellstar Health System, Inc.

  • Point of Service
  • Marietta, GA
  • NPI 1437219656

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1841249778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SANDY PLAINS ROAD",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 HIRAM DR BLDG B",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "30141",
            "telephone_number": "678-945-8300",
            "fax_number": "770-445-2060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5150 Stilesboro Rd NW",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Kennesaw",
            "state": "GA",
            "postal_code": "301527744",
            "country_code": "US",
            "telephone_number": "770-424-8222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5150 Stilesboro Rd NW",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Kennesaw",
            "state": "GA",
            "postal_code": "301527744",
            "country_code": "US",
            "telephone_number": "770-424-8222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMPEN",
        "first_name": "KATHLEEN",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-08",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "044454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kempen21452@directwellstar.org",
            "affiliation": "N",
            "address_1": "51 Hiram Dr Bldg B",
            "city": "Hiram",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301411844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Denise Rae Etter, PT

• Pediatrics Physician in Hiram, GA
• Providers in Hiram, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.