Individual provider Active NPI

Kelly Marie McDowell

  • Family Nurse Practitioner
  • McDonough, GA
National Provider Identifier
1174877195
Registry record updated Nov 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN154424 Issued in GA
Practice address
1227 Persimmon Way
McDonough, GA 30252-8438
Phone
(678) 315-5766
NPI assigned
Oct 29, 2012
Last updated
Nov 18, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2015

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 RN154424 GA Primary

Addresses

Primary practice location

1227 Persimmon Way
McDonough, GA 30252-8438

Mailing address

3390 Peachtree Nerd 1500
Atlanta, GA 30326-2822
Phone (404) 403-8310

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
I20130326000576 GA Practitioner - Nurse Practitioner 7911142773 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1388 Wellbrook Necir a
Conyers, GA 30012-3872
Phone (770) 929-9033

Merit-based Incentive Payment System (MIPS)

Final score
83.66 of 100Reported as group
Quality
74.46
Promoting interoperability
99
Improvement activities
40
Cost
71.9

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Specialty Associates, LLC CurrentSince Jan 15, 2013 Accepting new patients
The Interventional Spine and Pain Management Center PC CurrentSince Jan 1, 2015 Accepting new patients
The Interventional Spine and Pain Management Center, PC CurrentSince Jan 1, 2015 Accepting new patients
CPM Labs, LLC Current Accepting new patients

Locations

1821 Clifton Rd NE
Atlanta, GA 30329
Phone (404) 728-6812

3390 Peachtree Rd NE
Ste 1500
Atlanta, GA 30326
Phone 40492049502501

1388 Wellbrook Cir NE
#A
Conyers, GA 30012
Phone (770) 385-7985

Interoperability endpoints

  • Direct secure messaging: kelly.mcdowell@ispm.eclinicaldirectplus.com

Organizations & group practices 4

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": "1351468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1174877195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3390 PEACHTREE NERD 1500",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303262822",
            "telephone_number": "404-403-8310",
            "fax_number": "404-920-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 PERSIMMON WAY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302528438",
            "telephone_number": "678-315-5766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOWELL",
        "first_name": "KELLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-29",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN154424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

Verify at the official NPI Registry.