Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mary Kathryn Peabody, PA-C

Individual provider Physician Assistant · NPI 1609459577

Mary Kathryn Peabody, PA-C is a Physician Assistant in Johns Creek, Georgia. Qualified in 2020, 6 years ago. Practices with Advanced Urology Institute of Georgia, a 56-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
6
Licensed in
GA
In the registry since
2021
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

10730 Medlock Bridge Rd
Johns Creek, GA 30097-2637
Phone: (404) 948-4073
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 10377 (GA)
Physician Assistant Taxonomy 363A00000X
Surgical Physician Assistant Taxonomy 363AS0400X

Record details

NPI number1609459577
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 29, 2021
Last updated in NPPESDecember 12, 2022
Certification dateDecember 12, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Advanced Urology Institute Of Georgia — 56 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Johns Creek