Kathleen G Funk, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

037997 Issued in GA

Practice address

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606

Phone

(404) 851-6936

NPI assigned

Feb 14, 2006

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

Other identifiers 8

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

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.

• Gwinnett Emergency Specialists Observation Services, LLC

  • Emergency Medicine Physician
  • Lawrenceville, GA
  • NPI 1720373129
  Medicare reassignment NPD
• Northside Primary Care Professional Services,LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1922397553
  NPD (past)

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229644800000",
    "number": "1841264140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2968",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301569117",
            "telephone_number": "770-779-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421606",
            "telephone_number": "404-851-6936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "KATHLEEN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2008-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "037997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000779688C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF GEORGIA",
            "identifier": "920400",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000779688",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000779688D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE OF GEORGIA",
            "identifier": "333404",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10038142",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "10472",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF GEORGIA",
            "identifier": "202976",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eric Dee Funderburg, RPH
• Michael Phillip Fundora, M.D.
• Nicholas Kin-Man Fung, MD
• Yun Mei Fung, M.D.
• Joseph P Funk, MD
• Roni Stiller Funk, PH.D.
• Sidney A Funk, M.D.
• Shelli Funt, DDS
• Kara Fur, MSN, APRN, FNP-BC
• Cathy L Furbish, PT

• Emergency Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; 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.