Individual provider Active NPI

Kristin Cadavos, PA-C

  • Medical Physician Assistant
  • Augusta, GA
National Provider Identifier
1851845960
Registry record updated Aug 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
8053 Issued in GA
Practice address
1456 Walton Way
Ste a
Augusta, GA 30901-2674
Phone
(706) 941-8358
NPI assigned
Aug 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 8053 GA Primary

Addresses

Primary practice location

1456 Walton Way
Ste a
Augusta, GA 30901-2674

Mailing address

1456 Walton Way
Ste a
Augusta, GA 30901-2674
Phone (706) 941-8358

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
8053GAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1470355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470355200000",
    "number": "1851845960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 WALTON WAY",
            "address_2": "STE A",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012674",
            "telephone_number": "706-941-8358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1456 WALTON WAY",
            "address_2": "STE A",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012674",
            "telephone_number": "706-941-8358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CADAVOS",
        "first_name": "KRISTIN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-05",
        "last_updated": "2016-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "8053",
            "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 Aug 5, 2016; 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.