Amanarh Albert Kisseih, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

020880 Issued in GA

Practice address

1000 Medical Center Blvd
Lawrenceville, GA 30045-7694

Phone

(678) 442-3317

Fax

(678) 442-4416

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013039064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 SILVER HILL RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300871635",
            "telephone_number": "770-270-0505",
            "fax_number": "678-442-4416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300457694",
            "telephone_number": "678-442-3317",
            "fax_number": "678-442-4416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSEIH",
        "first_name": "AMANARH",
        "middle_name": "ALBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "020880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00342702A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kins Health Care and Services LLC
• Amy Sorrells Kirby
• Marilyn A Kirkland, LCSW
• Khalia Kirton
• Anthony A Kiss, PT
• Melanie Elizabeth Kissell
• Daria Kissina
• Nikeeta C Kitchen
• Rachel Calysta Kitchens-Cole, LCSW
• Sarah Kiwanuka, APRN

• Emergency Medicine Physician in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.