Kays Urgent Care Clinic LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

KAYS URGENT CARE CLINIC LLC

Practice address

4171 Marietta St
Powder Springs, GA 30127-2696

Phone

(678) 549-2323

Fax

(404) 609-1268

NPI assigned

Jun 25, 2022

Organization subpart

No

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

Authorized official

Name

Kay Yetunde Johnson, NPNPI 1790167856

Title

Owner

Phone

(678) 549-2323

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• KAYS URGENT CARE CLINC Former legal business name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Interoperability endpoints

• Direct secure messaging: admin@kaysurgentcare.com

Practitioners 4

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

• Kay Yetunde Johnson, NP

  • Family Nurse Practitioner
  • Smyrna, GA
  • NPI 1790167856
  Medicare reassignment NPD Authorized official
• Ikeade Bello Alamu, NP-C

  • Family Nurse Practitioner
  • Marietta, GA
  • NPI 1285013714
  Medicare reassignment NPD
• Richardson Desmangles, FNP-C

  • Family Nurse Practitioner
  • Atlanta, GA
  • NPI 1467100487
  Medicare reassignment NPD
• Stella Juliet Duru, FNP-C

  • Family Nurse Practitioner
  • Mableton, GA
  • NPI 1407209455
  Medicare reassignment NPD

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

{
    "created_epoch": "1656115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724112000000",
    "number": "1154053510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4171 MARIETTA ST",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301272696",
            "telephone_number": "678-549-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4171 MARIETTA ST",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301272696",
            "telephone_number": "678-549-2323",
            "fax_number": "404-609-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAYS URGENT CARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-25",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KAY",
        "authorized_official_middle_name": "YETUNDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-549-2323",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790167856",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Admin@kaysurgentcare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1700 Northside Dr NW Ste 7Pmb2370",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303182673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "KAYS URGENT CARE CLINC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "KAYS URGENT CARE CLINC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Primary Care Clinic/Center in Powder Springs, GA
• Providers in Powder Springs, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.