Active NPI
Dr. Kissing OB & GYN
- Specialist
- Norcross, GA
National Provider Identifier
1003244765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 64125
- Legal business name
- DR. KISSING OB & GYN
- Practice address
- 5720 Buford Hwy
102
Norcross, GA 30071-2577 - Phone
- (770) 888-3102
- Fax
- (770) 212-2188
- NPI assigned
- Oct 16, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Dominik Kissing, M.D.
- Title
- Owner
- Phone
- (770) 888-3102
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 64125 | GA | Primary |
Addresses
Primary practice location
5720 Buford Hwy
102
Norcross, GA 30071-2577
Mailing address
5720 Buford Hwy
102
Norcross, GA 30071-2577
Phone (770) 888-3102
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003112332D | Medicaid | GA |
National Provider Directory
National Provider Directory- Tax ID family
- Dr Kissing OB GYN
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Specialist
- Lawrenceville, GA
- NPI 1720416480
-
- Specialist
- Cumming, GA
- NPI 1891122677
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381881600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1381881600000",
"number": "1003244765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5720 BUFORD HWY",
"address_2": "102",
"city": "NORCROSS",
"state": "GA",
"postal_code": "300712577",
"telephone_number": "770-888-3102",
"fax_number": "770-212-2188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5720 BUFORD HWY",
"address_2": "102",
"city": "NORCROSS",
"state": "GA",
"postal_code": "300712577",
"telephone_number": "770-888-3102",
"fax_number": "770-212-2188"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DR. KISSING OB & GYN",
"organizational_subpart": "NO",
"enumeration_date": "2013-10-16",
"last_updated": "2013-10-16",
"status": "A",
"authorized_official_last_name": "KISSING",
"authorized_official_first_name": "DOMINIK",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "770-888-3102",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "GA",
"license": "64125",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003112332D",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Norcross, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.