Active NPI
Lindsay Susanne Kibuyaga, MD
- Pediatrics Physician
- Atlanta, GA
National Provider Identifier
1144546508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 70187
- Practice address
- 1405 Clifton Rd NE
Atlanta, GA 30322-1060 - Phone
- (404) 785-7141
- Fax
- (404) 785-7989
- NPI assigned
- Apr 9, 2010
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 70187 | GA | Primary |
Addresses
Primary practice location
1405 Clifton Rd NE
Atlanta, GA 30322-1060
Mailing address
1405 Clifton Rd NE
Atlanta, GA 30322-1060
Phone (404) 785-7141
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | choa@choa.gadirect.net |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emory Medical Care Foundation Inc | Current | Accepting new patients | |
| Emory Medical Care Foundation Inc | Pediatrics | Current | Accepting new patients |
| Emory Medical Care Foundation Inc | Current | Accepting new patients |
Locations
80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370
1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112
35 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 785-9500
101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889
Interoperability endpoints
- lkibuyaga41360@choa.gadirect.net
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.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1063452381
-
- Diagnostic Radiology Physician
- Atlanta, GA
- NPI 1225294739
-
- Pediatrics Physician
- Atlanta, GA
- NPI 1730345240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1654473600000",
"number": "1144546508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1405 CLIFTON RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221060",
"telephone_number": "404-785-7141",
"fax_number": "404-785-7989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1405 CLIFTON RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303221060",
"telephone_number": "404-785-7141",
"fax_number": "404-785-7989"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIBUYAGA",
"first_name": "LINDSAY",
"middle_name": "SUSANNE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-09",
"last_updated": "2022-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "GA",
"license": "70187",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "choa@choa.gadirect.net",
"affiliation": "N",
"address_1": "1405 Clifton Rd NE",
"city": "Atlanta",
"state": "GA",
"country_code": "US",
"postal_code": "303221060",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.