Individual provider Active NPI

Kristopher Nelson, DO

  • Family Medicine Physician
  • Lagrange, GA
National Provider Identifier
1205451101
Registry record updated Jun 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
94447 Issued in GA
Practice address
380 S Davis Rd Ste E
Lagrange, GA 30241-2588
Phone
(706) 882-8831
NPI assigned
Jun 16, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 12026 GA
Family Medicine Physician 207Q00000X 94447 GA Primary

Addresses

Primary practice location

380 S Davis Rd Ste E
Lagrange, GA 30241-2588

Mailing address

380 S Davis Rd Ste E
Lagrange, GA 30241-2588
Phone (706) 882-8831

Other practice location 1

2782 N Cobb Pkwy
Kennesaw, GA 30152-3472
Phone (866) 389-2727

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230605001776 GA Practitioner - Family Practice 9537582093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emory Specialty Associates, LLCGroup PAC ID 3476559782, 706 clinicians

Practice addresses (Care Compare)

1821 Clifton Rd NE
Atlanta, GA 30329-4021
Phone (404) 728-6812

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Columbus, GA, CCN 117056
  • Adoration Home Health Home health agency, Columbus, GA, CCN 117318
  • West Georgia Home Care Home health agency, Lagrange, GA, CCN 117032
  • Wellstar West Georgia Medical Center Hospital, Lagrange, GA, CCN 110016

Merit-based Incentive Payment System (MIPS)

Final score
94.51 of 100Reported as apm
Quality
80.61
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
94447GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Specialty Associates, LLC Family Medicine CurrentSince Jul 1, 2023 Accepting new patients

Locations

2201 Henderson Mill Rd NE
Ste 160
Atlanta, GA 30345
Phone (404) 251-2193

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

380 S Davis Rd
Ste E
Lagrange, GA 30241
Phone (706) 882-8831

1610 E 10th St
West Point, GA 31833
Phone (706) 298-4823

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780963200000",
    "number": "1205451101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 S DAVIS RD STE E",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302412588",
            "telephone_number": "706-882-8831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 S DAVIS RD STE E",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302412588",
            "telephone_number": "706-882-8831"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2782 N Cobb Pkwy",
            "address_purpose": "LOCATION",
            "city": "Kennesaw",
            "state": "GA",
            "postal_code": "301523472",
            "country_code": "US",
            "telephone_number": "866-389-2727",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NELSON",
        "first_name": "KRISTOPHER",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-16",
        "last_updated": "2026-06-09",
        "certification_date": "2026-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "12026",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "94447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.