Kelley S Wharton (NPI# 1902061864, PAC ID# 0244308443) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1902061864 |
| PAC ID by PECOS | 0244308443 |
| Professional Enrollment ID | I20081001000070 |
| Full Name | Kelley S Wharton |
| Organization Legal Name | DEKALB MEDICAL PRIMARY CARE GROUP LLC |
| Address |
487 Winn Way Decatur GA 30333-1728 |
| Phone Number | 4042940702 |
| Gender | F |
| Graduation Year | 2008 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 1557411162 |
| Number of Group Practice Members | 73 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 110192 | EASTSIDE MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 487 Winn Way, Decatur, GA 30333-1728 | 4042940702 | DEKALB MEDICAL PRIMARY CARE GROUP LLC |
| 487 Winn Way, Suite 202, Decatur, GA 30333-1728 | 4042940702 | DEKALB MEDICAL PRIMARY CARE GROUP LLC |
| Organization Legal Name | DEKALB MEDICAL PRIMARY CARE GROUP LLC |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christina B Knox | Physician Assistant | Dekalb Medical Primary Care Group LLC | 200 E Ponce De Leon Ave, Suite 110, Decatur, GA 30030-3467 |
| Shahid Rafique | Internal Medicine | Dekalb Medical Primary Care Group LLC | 2356 Lenora Church Rd, Snellville, GA 30078-3233 |
| Charles D Barclay | Family Practice | Dekalb Medical Primary Care Group LLC | 487 Winn Way, Suite 202, Decatur, GA 30333-1728 |
| Vera A Reaves | Family Practice | Dekalb Medical Primary Care Group LLC | 487 Winn Way, Suite 202, Decatur, GA 30333-1728 |
| John H Ahrendt | Family Practice | Dekalb Medical Primary Care Group LLC | 2356 Lenora Church Rd, Snellville, GA 30078-3233 |
| John W Budell | Internal Medicine | Dekalb Medical Primary Care Group LLC | 487 Winn Way, Decatur, GA 30333-1728 |
| David J Roth | Internal Medicine | Dekalb Medical Primary Care Group LLC | 487 Winn Way, Decatur, GA 30333-1728 |
| Sharon R Rabinovitz | Family Practice | Dekalb Medical Primary Care Group LLC | 487 Winn Way, Suite 202, Decatur, GA 30333-1728 |
| Dean S Attaway | Family Practice | Dekalb Medical Primary Care Group LLC | 487 Winn Way, Suite 202, Decatur, GA 30333-1728 |
| Street Address |
487 WINN WAY |
| City | DECATUR |
| State | GA |
| Zip | 30333-1728 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cecil M Anderson Iii | Physical Therapy | 487 Winn Way, Suite 201, Decatur, GA 30030-1728 | |
| Charles D Barclay | Family Practice | Dekalb Medical Primary Care Group LLC | 487 Winn Way, Suite 202, Decatur, GA 30333-1728 |
| Vera A Reaves | Family Practice | Dekalb Medical Primary Care Group LLC | 487 Winn Way, Suite 202, Decatur, GA 30333-1728 |
| Charles L. Owen Jr. | Physical Therapy | 487 Winn Way, Suite 201, Decatur, GA 30030-1728 | |
| John W Budell | Internal Medicine | Dekalb Medical Primary Care Group LLC | 487 Winn Way, Decatur, GA 30333-1728 |
| David J Roth | Internal Medicine | Dekalb Medical Primary Care Group LLC | 487 Winn Way, Decatur, GA 30333-1728 |
| Sharon R Rabinovitz | Family Practice | Dekalb Medical Primary Care Group LLC | 487 Winn Way, Suite 202, Decatur, GA 30333-1728 |
| Dean S Attaway | Family Practice | Dekalb Medical Primary Care Group LLC | 487 Winn Way, Suite 202, Decatur, GA 30333-1728 |
| City | DECATUR |
| Zip Code | 30333 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | DECATUR + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Kelley S Wharton.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.