NPIMap

Organization Active NPI

Rediclinic Services

  • Family Nurse Practitioner
  • Acworth, GA
National Provider Identifier
1013066950
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN070078 Issued in GA
Legal business name
REDICLINIC SERVICES
Practice address
1762 Mars Hill Rd NW
Acworth, GA 30101-8091
Phone
(866) 935-0333
NPI assigned
Jan 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Chris Kersey, M.D.
Title
Director
Phone
(866) 935-0333

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X RN070078 GA Primary

Addresses

Primary practice location

1762 Mars Hill Rd NW
Acworth, GA 30101-8091

Mailing address

9 E Greenway PLZ
Suite 2950
Houston, TX 77046-0905

National Provider Directory

National Provider Directory
Tax ID family
Rediclinic18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013066950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 E GREENWAY PLZ",
            "address_2": "SUITE 2950",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770460905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1762 MARS HILL RD NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301018091",
            "telephone_number": "866-935-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDICLINIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KERSEY",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "18669350333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN070078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.