Active NPI
Kelly A Houmand, P.A.-C
- Medical Physician Assistant
- Marietta, GA
National Provider Identifier
1164795241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA0254
- Practice address
- 111 Marble Mill Rd NW
Marietta, GA 30060-1047 - Phone
- (770) 422-1013
- Fax
- (770) 514-5996
- NPI assigned
- Feb 20, 2012
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA0254 | NV | Primary |
Addresses
Primary practice location
111 Marble Mill Rd NW
Marietta, GA 30060-1047
Mailing address
111 Marble Mill Rd NW
Marietta, GA 30060-1047
Phone (770) 422-1013
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA0254 | NV | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stephen William Doggett, M.D. PA | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1164795241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 MARBLE MILL RD NW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601047",
"telephone_number": "770-422-1013",
"fax_number": "770-514-5996"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 MARBLE MILL RD NW",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601047",
"telephone_number": "770-422-1013",
"fax_number": "770-514-5996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOUMAND",
"first_name": "KELLY",
"middle_name": "A",
"credential": "P.A.-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-20",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "NV",
"license": "PA0254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.