NPIMap

Individual provider Active NPI

Byron Thomas Kelly, M.D.

  • Family Medicine Physician
  • Decatur, GA
National Provider Identifier
1033280466
Registry record updated Jan 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
032762 Issued in GA
Practice address
445 Winn Way
Decatur, GA 30030-1707
Phone
(404) 294-3835
Fax
(404) 508-7795
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 032762 GA Primary

Addresses

Primary practice location

445 Winn Way
Decatur, GA 30030-1707

Mailing address

445 Winn Way
Decatur, GA 30030-1707
Phone (404) 294-3835

Other identifiers 1

IdentifierTypeStateIssuer
00455749AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051013000926 GA Practitioner - Family PracticePractitioner - Emergency Medicine 1456376888 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Meharry Medical College School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pruitthealth Physicians Services LLCGroup PAC ID 8123327061, 17 clinicians

Practice addresses (Care Compare)

2560 Flintridge Rd
Gainesville, GA 30501-7425
Phone (770) 536-3391

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
032762GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care PA CurrentSince Apr 8, 2024 Accepting new patients
Pruitthealth Physicians Services, LLC Family Medicine CurrentSince Jul 20, 2025 Accepting new patients
American Current Care P.a. CurrentSince Apr 8, 2024 Accepting new patients
Recovery Consultants of Atlanta, Inc. CurrentSince Oct 10, 2023 Accepting new patients
Recovery Consultants of Atlanta, Inc. CurrentSince Oct 10, 2023 Accepting new patients
Apollomd Group Services, LLC Past Accepting new patients
Carter Emergency Physicians Past Accepting new patients
Morningside Emergency Physicians LLC Past Accepting new patients
The Oaks - Limestone, LLC Past Accepting new patients
Kayenta Alternative Rural Hospital Past Accepting new patients
Pruitthealth - Lilburn, LLC Past Accepting new patients
Pruitthealth - Lanier, LLC Past Accepting new patients
Hospitalmd of Georgia Ip, Inc Past Accepting new patients
County of St Louis Division of Fiscal Management Past Accepting new patients

Locations

688 Spring St NW
Atlanta, GA 30308
Phone (404) 881-1155

2451 Peachtree Industrial Blvd
Buford, GA 30518
Phone (770) 614-2800

4223 Moreland Ave
Conley, GA 30288
Phone (404) 366-2900

4229 Snapfinger Woods Dr
Decatur, GA 30035
Phone (404) 286-9252

2560 Flintridge Rd
Gainesville, GA 30501
Phone (770) 536-3391

1626 Jeurgens Ct
Norcross, GA 30093
Phone (770) 806-6875

1957 Lakeside Pkwy
Ste 510
Tucker, GA 30084
Phone (404) 289-0313

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DEGGAD

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454112000000",
    "number": "1033280466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 WINN WAY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301707",
            "telephone_number": "404-294-3835",
            "fax_number": "404-508-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 WINN WAY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301707",
            "telephone_number": "404-294-3835",
            "fax_number": "404-508-7795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "BYRON",
        "middle_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2016-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "032762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00455749A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.