Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Kimberly Miller Connally, PA-C

Individual provider Physician Assistant · NPI 1487856092

Mrs. Kimberly Miller Connally, PA-C is a Physician Assistant in Columbus, Georgia. Qualified in 2007, 19 years ago. Practices with Douglas Dermatology and Skin Cancer Specialists LLC, a 9-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
19
Licensed in
GA
In the registry since
2007
Specialties on file
2
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

1150 Brookstone Centre Pkwy
Columbus, GA 31904-4577
Phone: (706) 257-4189
Fax: (706) 257-4194
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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 5065 (GA)
Physician Assistant Taxonomy 363A00000X · Licence 1561 (GA)

Record details

NPI number1487856092
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJune 5, 2007
Last updated in NPPESMarch 23, 2022
Certification dateMarch 23, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Douglas Dermatology And Skin Cancer Specialists Llc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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