Kingsley Clinic of Georgia LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

KINGSLEY CLINIC OF GEORGIA LLC

Practice address

11720 Amberpark Dr Ste 160
Alpharetta, GA 30009-2271

Phone

(770) 580-1905

Fax

(912) 216-3703

NPI assigned

Nov 19, 2020

Organization subpart

No

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

Authorized official

Name

Dr. James Kingsley, MDNPI 1841687142

Title

Owner

Phone

(770) 580-1905

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 2

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

• James R Kingsley Jr., MD

  • Internal Medicine Physician
  • Menifee, CA
  • NPI 1841687142

  GA

  Medicare reassignment Authorized official
• Amanda Michelle May Vanveckhoven

  • Physician Assistant
  • Frisco, TX
  • NPI 1275208431
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1124621487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33471 BILTMORE DR",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925921849",
            "telephone_number": "530-305-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11720 AMBERPARK DR STE 160",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300092271",
            "telephone_number": "770-580-1905",
            "fax_number": "912-216-3703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINGSLEY CLINIC OF GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-19",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "KINGSLEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-580-1905",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James L King, LPC
• James Patrick King, CHIROPRACTOR
• Lee Anna King, LPC
• Meschelle King
• Sierra King
• Gia Kirk
• Martha Virginia Kirkland, DMD MS
• Peter Zachary Kissell, M.ED., M.S.
• Keith Edward Kitchens, D.M.D.
• Kailee Kivett

• Internal Medicine Physician in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.