Individual provider Active NPI

Kendall Elizabeth Towe, PA-C

  • Dermatology Physician
  • Lawrenceville, GA
National Provider Identifier
1063190585
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
11722 Issued in GA
Practice address
2000 Riverside Pkwy Ste 100
Lawrenceville, GA 30043-5926
Phone
(678) 535-0067
NPI assigned
Jul 5, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X 11722 GA
Dermatology Physician 207N00000X 11722 GA Primary

Addresses

Primary practice location

2000 Riverside Pkwy Ste 100
Lawrenceville, GA 30043-5926

Mailing address

4580 Barony Dr
Suwanee, GA 30024-6949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew J. Reschly, MD, PC Dermatology CurrentSince Jul 9, 2023 Accepting new patients

Locations

2000 Riverside Pkwy
Ste 100
Lawrenceville, GA 30043
Phone (470) 273-7233

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": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1063190585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4580 BARONY DR",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 RIVERSIDE PKWY STE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435926",
            "telephone_number": "678-535-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOWE",
        "first_name": "KENDALL",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "GA",
            "license": "11722",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "11722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.