Individual provider Active NPI

Karine Gelin, R PA-C

  • Physician Assistant
  • Suwanee, GA
National Provider Identifier
1003065046
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
25MP00553400 Issued in NJ
Practice address
2696 Lawrenceville Suwanee Rd
Suwanee, GA 30024-2535
Phone
(678) 376-1300
Fax
(678) 514-2936
NPI assigned
Sep 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 012760 NY
Physician Assistant 363A00000X 5984 GA
Physician Assistant 363A00000X 25MP00553400 NJ Primary

Addresses

Primary practice location

2696 Lawrenceville Suwanee Rd
Suwanee, GA 30024-2535

Mailing address

1000 Johnson Ferry Rd
Atlanta, GA 30342-1606
Phone (404) 303-3617

Other identifiers 1

IdentifierTypeStateIssuer
003100804FMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101213000180 GA Practitioner - Physician Assistant 6002977188 Reassigns benefits to 1 organization
I20200127000628 NJ Practitioner - Physician Assistant 6002977188 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
012760NYMDSpeech-Language Pathologist
5984GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Grady Memorial Hospital Corporation CurrentSince Aug 18, 2012 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Mar 24, 2024 Accepting new patients
Grady Memorial Hospital Corporation CurrentSince Aug 18, 2012 Accepting new patients
Tree Lane Inpatient Services LLC Physician Assistant Past Accepting new patients
The Radiology Group of New Jersey, LLC Past Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715644800000",
    "number": "1003065046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421606",
            "telephone_number": "404-303-3617",
            "fax_number": "678-388-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2696 LAWRENCEVILLE SUWANEE RD",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242535",
            "telephone_number": "678-376-1300",
            "fax_number": "678-514-2936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELIN",
        "first_name": "KARINE",
        "credential": "R PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012760",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "5984",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00553400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003100804F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.