Individual provider Active NPI

Balwinder Kaur, NP

  • Family Nurse Practitioner
  • Norcross, GA
National Provider Identifier
1154364123
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN141621 Issued in GA
Practice address
5985 Peachtree Pkwy
Norcross, GA 30092-2818
Phone
(770) 449-0990
Fax
(770) 448-8818
NPI assigned
Jun 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN141621 GA Primary

Addresses

Primary practice location

5985 Peachtree Pkwy
Norcross, GA 30092-2818

Mailing address

2905 Pinehigh CT
Duluth, GA 30096-7060
Phone (770) 449-3251

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040701000534 GA Practitioner - Nurse Practitioner 9830176593 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Primary Care Professional Services, LLC CurrentSince Dec 1, 2015 Accepting new patients
Northside Primary Care Professional Services,LLC CurrentSince Dec 1, 2015 Accepting new patients
Rediclinic LLC Past Accepting new patients

Locations

3350 Paddocks Pkwy
Suwanee, GA 30024
Phone (678) 474-9633

3350 Paddocks Pkwy
#3350A
Suwanee, GA 30024
Phone (678) 474-9633

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154364123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 PINEHIGH CT",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300967060",
            "telephone_number": "770-449-3251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5985 PEACHTREE PKWY",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300922818",
            "telephone_number": "770-449-0990",
            "fax_number": "770-448-8818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUR",
        "first_name": "BALWINDER",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN141621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

Verify at the official NPI Registry.