Individual provider Active NPI

Nelson Kevin Tanefo Kuete, MD

  • Urology Physician
  • Carrollton, GA
National Provider Identifier
1063096154
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
113551 Issued in GA
Practice address
150 Clinic Ave Ste 202
Carrollton, GA 30117-4402
Phone
(770) 834-6988
Fax
(770) 834-1090
NPI assigned
May 6, 2021
Last updated
Sep 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 113551 GA Primary

Addresses

Primary practice location

150 Clinic Ave Ste 202
Carrollton, GA 30117-4402

Mailing address

6911 Slate Stone Way SE
Mableton, GA 30126-5425
Phone (770) 827-9756

Other names 1

  • Nelson Kevin Tanefo Kuete Other name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260624002541 GA Practitioner - Urology 6305248071

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Morehouse School of Medicine, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

100 Greenway Blvd
Carrollton, GA 30117-4338

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13472GAMDPhysician Assistant

Hospital & facility affiliations 3

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": "1620259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789516800000",
    "number": "1063096154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6911 SLATE STONE WAY SE",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301265425",
            "telephone_number": "770-827-9756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CLINIC AVE STE 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174402",
            "telephone_number": "770-834-6988",
            "fax_number": "770-834-1090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUETE",
        "first_name": "NELSON KEVIN",
        "middle_name": "TANEFO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-06",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "113551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NELSON",
            "last_name": "KUETE",
            "middle_name": "KEVIN TANEFO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.