Individual provider Active NPI

Kim Vu Neisler, MD

  • Radiation Oncology Physician
  • Stockbridge, GA
National Provider Identifier
1093760217
Registry record updated Oct 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
56239 Issued in GA
Practice address
960 Hospital Dr
Stockbridge, GA 30281-7345
Phone
(678) 251-1099
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 56239 GA Primary

Addresses

Primary practice location

960 Hospital Dr
Stockbridge, GA 30281-7345

Mailing address

960 Hospital Dr
Stockbridge, GA 30281-7345
Phone (678) 251-1099

Other identifiers 2

IdentifierTypeStateIssuer
900520OtherGABCBS
945221OtherGABCBS

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
I20050617000556 GA Practitioner - Radiation Oncology 4385688530 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
University of Tennessee, HSC, College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapeutic Radiation Oncology, PCGroup PAC ID 2163325812, 8 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 251-1099

Hospital & facility affiliations

  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56239GAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Radiation Oncology Center, LLC Radiation Oncology CurrentSince Jul 1, 2010 Accepting new patients
Newnan Regional Radiation Therapy Center, Inc. Radiation Oncology CurrentSince Aug 1, 2005 Accepting new patients
City of Hope Medical Group of Georgia LLC Radiation Oncology CurrentSince Mar 5, 2013 Accepting new patients
Griffin Regional Radiation Therapy Center, Inc. Radiation Oncology Current Accepting new patients
Therapeutic Radiation Oncology, PC Radiation Oncology CurrentSince Aug 1, 2005 Accepting new patients

Locations

1968 Ptree Rd NW
Atlanta, GA 30309
Phone (404) 605-2222

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

1800 Hospital South Dr
Austell, GA 30106
Phone (770) 793-7196

1136 Cleveland Ave
Ste 119
East Point, GA 30344
Phone (404) 305-4580

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

725 S 8th St
Griffin, GA 30224
Phone (404) 222-9411

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

600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334

255 Professional Ct
Riverdale, GA 30274
Phone (770) 907-0554

275 Professional Ct
#B
Riverdale, GA 30274
Phone (770) 907-0554

960 Hospital Dr
Stockbridge, GA 30281
Phone (770) 907-0554

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

62742 Collections Ctr Dr
Chicago, IL 60693

Interoperability endpoints

  • Direct secure messaging: kneisler@directaddress.net

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381276800000",
    "number": "1093760217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 HOSPITAL DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817345",
            "telephone_number": "678-251-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 HOSPITAL DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817345",
            "telephone_number": "678-251-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEISLER",
        "first_name": "KIM",
        "middle_name": "VU",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2013-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "GA",
            "license": "56239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "900520",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "945221",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

Verify at the official NPI Registry.