Individual provider Active NPI

Denise Lowman-Kedzierski, NP-C

  • Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1093954562
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN168434 Issued in GA
Practice address
355 Tower Rd NE
Suite 300
Marietta, GA 30060-9408
Phone
(770) 426-4721
Fax
(770) 424-0391
NPI assigned
Feb 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN168434 GA Primary

Addresses

Primary practice location

355 Tower Rd NE
Suite 300
Marietta, GA 30060-9408

Mailing address

355 Tower Rd NE
Suite 300
Marietta, GA 30060-9408
Phone (770) 426-4721

Other identifiers 1

IdentifierTypeStateIssuer
862338670AMedicaidGA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090526000403 GA Practitioner - Nurse Practitioner 6608925516 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Professional Services LLCGroup PAC ID 8921176231, 171 clinicians

Practice addresses (Care Compare)

2988 Shallowford Rd
Marietta, GA 30066-3033
Phone (678) 732-1527

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Professional Services, LLC CurrentSince Aug 1, 2017 Accepting new patients
The Emory Clinic Inc CurrentSince Jan 1, 2010 Accepting new patients
Piedmont Medical Care Corporation Past Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1267 Highway 54 W
Ste 2200
Fayetteville, GA 30214
Phone (470) 271-3415

2779 N Cobb Pkwy NW
Kennesaw, GA 30152
Phone (678) 732-1516

2988 Shallowford Rd
Marietta, GA 30066
Phone (678) 560-1871

695 W Crossville Rd
Roswell, GA 30075
Phone (678) 732-1531

Organizations & group practices 3

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": "1233878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1093954562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 TOWER RD NE",
            "address_2": "SUITE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609408",
            "telephone_number": "770-426-4721",
            "fax_number": "770-424-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 TOWER RD NE",
            "address_2": "SUITE 300",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300609408",
            "telephone_number": "770-426-4721",
            "fax_number": "770-424-0391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWMAN-KEDZIERSKI",
        "first_name": "DENISE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-06",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN168434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "862338670A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.