Kisha Adderley, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN185219 Issued in GA

Practice address

1775 Parker Rd SE
Ste C-240
Conyers, GA 30094-6654

Phone

(678) 609-6282

Fax

(678) 609-6283

NPI assigned

Dec 8, 2014

Last updated

Dec 8, 2014By the provider in NPPES

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)

Enrolled

Practice roles

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.

• Piedmont Providers LLC

  • Internal Medicine Physician
  • Jasper, GA
  • NPI 1548273592
  NPD (past)

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417996800000",
    "number": "1174921175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 116202",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303686202",
            "telephone_number": "678-609-6282",
            "fax_number": "678-609-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 PARKER RD SE",
            "address_2": "STE C-240",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946654",
            "telephone_number": "678-609-6282",
            "fax_number": "678-609-6283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADDERLEY",
        "first_name": "KISHA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-08",
        "last_updated": "2014-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN185219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Active Care Medical Associates of Conyers, LLC
• Adams Behavioral Consulting
• Julianne Adams Birt, M.D.
• Joseph Adams
• Kendia Adams, LPC
• Olapeju Grace Aderinwale, PHARMD
• Brian C Adkisson, RN
• Adult Health Consultants of Atlanta, P.C.
• Advanced Gynecology, PC (Advanced Gynecology Conyers)
• Advanced Southern Imaging LLC

• Family Nurse Practitioner in Conyers, GA
• Providers in Conyers, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; 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.