Romualda S Klicius, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

046305 Issued in GA

Practice address

2230 Towne Lake Pkwy
Building 300, Suite 100
Woodstock, GA 30189-5540

Phone

(770) 517-1900

Fax

(770) 926-3215

NPI assigned

Oct 20, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Gibson Community Hospital Association

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323648000000",
    "number": "1033108121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 TOWNE LAKE PKWY",
            "address_2": "BUILDING 300, SUITE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895540",
            "telephone_number": "770-517-1900",
            "fax_number": "770-926-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 TOWNE LAKE PKWY",
            "address_2": "BUILDING 300, SUITE 100",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895540",
            "telephone_number": "770-517-1900",
            "fax_number": "770-926-3215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLICIUS",
        "first_name": "ROMUALDA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-20",
        "last_updated": "2011-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "046305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Srilaxmi Andikot Kishor, MD
• Brittany Poist Kizzire, PT, DPT
• KJK Compassion Care LLC
• Jacob John Klebar, PT, DPT, CSCS
• Matthew D. Klein, L.P.C.
• Kenneth David Kligman, D.D.S.
• Tracie Lynn Knauf, MA, CCC-SLP
• Brittany Paris Knight
• Essence Knight
• Sarah Knoblach, OTA

• Pediatrics Physician in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2011; 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.