Individual provider Active NPI

Krystal Gail Dennis, NP

  • Nurse Practitioner
  • Fayetteville, GA
National Provider Identifier
1023995495
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN-NP304643 Issued in GA
Practice address
1255 Highway 54 W
Fayetteville, GA 30214-4526
Phone
(770) 716-0051
NPI assigned
Aug 18, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN-NP304643 GA Primary
Family Nurse Practitioner 363LF0000X RN304643 GA

Addresses

Primary practice location

1255 Highway 54 W
Fayetteville, GA 30214-4526

Mailing address

1001 Mill Creek CT
Conyers, GA 30012-6515
Phone (470) 998-5060

Other practice location 1

1001 Mill Creek Ct
Conyers, GA 30012-6515
Phone (470) 998-5060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260121002540 GA Practitioner - Nurse Practitioner 4789161761 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians

Practice addresses (Care Compare)

1267 Hwy 54 W
Suite 2200
Fayetteville, GA 30214
Phone (770) 716-0051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-NP304643GAMDNurse Practitioner
RN304643GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Cardiology of Atlanta, LLC CurrentSince Mar 2, 2026 Accepting new patients

Locations

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

745 Poplar Rd
Newnan, GA 30265
Phone (404) 478-8785

Organizations & group practices 1

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": "1755475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1023995495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MILL CREEK CT",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300126515",
            "telephone_number": "470-998-5060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 HIGHWAY 54 W",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144526",
            "telephone_number": "770-716-0051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Mill Creek Ct",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300126515",
            "country_code": "US",
            "telephone_number": "470-998-5060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "KRYSTAL",
        "middle_name": "GAIL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-18",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "APRN-NP304643",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN304643",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.