Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kellie Elise Wydrinski, PAC

Individual provider Physician Assistant · NPI 1184471377

Kellie Elise Wydrinski, PAC is a Physician Assistant in Atlanta, Georgia. Qualified in 2024, 2 years ago. Practices with Aga Professional Services LLC, a 173-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
2
Licensed in
GA
In the registry since
2024
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

980 Johnson Ferry Rd Ste 820
Atlanta, GA 30342-1608
Phone: (404) 252-9307
Fax: (404) 252-5839
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 12383 (GA)

Record details

NPI number1184471377
Entity typeIndividual (Type 1)
GenderFemale
Credentials PAC
Sole proprietorNo
NPI enumeratedMay 4, 2024
Last updated in NPPESJuly 12, 2024
Certification dateJune 10, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Aga Professional Services Llc — 173 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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