NPIMap

Kaiser Permanente

Organization Active NPI Clinical Medical Laboratory · Newnan, GA

NPI 1114229341 · NPPES record last updated Jul 15, 2021

Key facts

NPI
1114229341
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
Legal business name
KAISER PERMANENTE
Practice address
203 Newnan Crossing Byp
Newnan, GA 30265-1063
Phone
(770) 304-4400
Fax
(770) 304-4401
NPI assigned
Nov 19, 2010
Organization subpart
No

Authorized official

Name
Katherine Farmer
Title
Director of Laboratory Services
Phone
(404) 309-9314

Corporate family (same tax ID) 20

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Kaiser Foundation Health (67 organizations share this tax ID)

Locations

203 Newnan Crossing Byp
Newnan, GA 30265
Phone (770) 304-4400

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 11D2015700 GA
Clinical Medical Laboratory 291U00000X Yes

Addresses

Primary practice location

203 Newnan Crossing Byp
Newnan, GA 30265-1063

Mailing address

3495 Piedmont Rd NE
Atlanta, GA 30305-1717

Electronic endpoints

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 15, 2021.

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1114229341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 NEWNAN CROSSING BYP",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651063",
            "telephone_number": "770-304-4400",
            "fax_number": "770-304-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER PERMANENTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-19",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "FARMER",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "DIRECTOR OF LABORATORY SERVICES",
        "authorized_official_telephone_number": "404-309-9314"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "GA",
            "license": "11D2015700",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3495 Piedmont Rd NE",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303051717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newnan, GA

All providers in Newnan, GA · Clinical Medical Laboratory in Georgia

Sources for this page

Verify at the official NPI Registry.