NPIMap

Individual provider Active NPI

Holly Kay Taylor, PA-C

  • Surgical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1205943776
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
005511 Issued in GA
Practice address
5665 Peachtree Dunwoody Rd.,
Suite 150
Atlanta, GA 30342
Phone
(404) 252-6104
Fax
(404) 257-1808
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 50-001788 OH
Surgical Physician Assistant 363AS0400X 0010-00319 NC
Surgical Physician Assistant 363AS0400X 005511 GA Primary

Addresses

Primary practice location

5665 Peachtree Dunwoody Rd.,
Suite 150
Atlanta, GA 30342

Mailing address

PO Box 70547
Marietta, GA 30007
Phone (770) 579-1894

Other identifiers 1

IdentifierTypeStateIssuer
0359PAMedicaidSC

Other names 1

  • Holly Kay Smith Former name

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

LicenseStateTypeSpecialty
0010-00319NCMDSurgical Physician Assistant
50-001788OHMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Hospital Holding Company Past Accepting new patients
Peachatree Cardiovascular & Thoracic Surgeons, P.a. PastSince Jul 23, 1992 Accepting new patients
Three Rivers Cardiac Institute Inc. Past Accepting new patients
Peachtree Cardiovascular Surgeons at Saint Joseph's LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1205943776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70547",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30007",
            "telephone_number": "770-579-1894",
            "fax_number": "770-579-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5665 PEACHTREE DUNWOODY RD.,",
            "address_2": "SUITE 150",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30342",
            "telephone_number": "404-252-6104",
            "fax_number": "404-257-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "HOLLY",
        "middle_name": "KAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "OH",
            "license": "50-001788",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-00319",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "005511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0359PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "SMITH",
            "middle_name": "KAY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2018; 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.