Active NPI
Kalyn Prescott, LPN
- Licensed Practical Nurse
- Stone Mountain, GA
National Provider Identifier
1114653177
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 101151
- Practice address
- 1607 Barrington VW
Stone Mountain, GA 30087-1846 - Phone
- (678) 582-9317
- NPI assigned
- Jul 30, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 101151 | GA | Primary |
Addresses
Primary practice location
1607 Barrington VW
Stone Mountain, GA 30087-1846
Mailing address
1607 Barrington VW
Stone Mountain, GA 30087-1846
Phone (678) 582-9317
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9576376 | Other | GA | CIGNA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | admin@royalcareservice.org |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1659139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659139200000",
"number": "1114653177",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1607 BARRINGTON VW",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300871846",
"telephone_number": "678-582-9317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1607 BARRINGTON VW",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300871846",
"telephone_number": "678-582-9317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRESCOTT",
"first_name": "KALYN",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-30",
"last_updated": "2022-07-30",
"certification_date": "2022-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Licensed Practical Nurse",
"state": "GA",
"license": "101151",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "9576376",
"state": "GA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "admin@royalcareservice.org",
"affiliation": "N",
"address_1": "1607 Barrington Vw",
"city": "Stone Mountain",
"state": "GA",
"country_code": "US",
"postal_code": "300871846",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Stone Mountain, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.