Caroline Kelliny, PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

615-PA Issued in PR

Practice address

3770 Bridle Ridge Dr
Suwanee, GA 30024-1067

Phone

(678) 650-1298

NPI assigned

Jan 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Luxe Wellness MD

  • Internal Medicine Physician
  • Suwanee, GA
  • NPI 1659908226
  NPD Authorized official

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1164062550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3770 BRIDLE RIDGE DR",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241067",
            "telephone_number": "678-650-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3770 BRIDLE RIDGE DR",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300241067",
            "telephone_number": "678-650-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLINY",
        "first_name": "CAROLINE",
        "name_prefix": "Dr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "615-PA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Leigh Keane, BS, RBT
• Eurina Y Kee, RN, MS, CRRN
• Nyce Keiyoro
• Kelley Therapeutic Services LLC
• Lisa Danielle Kelley, LCSW
• Jena Kelly, OTR/L
• Lauren K Kelly, MA, LMFT
• Laprinces Elaine Kennard, BCBA, LBA
• Kurtis Kepfer, PT
• Judy Ann Kerley, PH.D.

• Internal Medicine Physician in Suwanee, GA
• Providers in Suwanee, 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 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.