Kiley Jordan Parrish

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11043 Issued in GA

Practice address

201 Michael Etchison Rd
Monroe, GA 30655-5996

Phone

(770) 476-7656

NPI assigned

Feb 24, 2022

Last updated

Jul 20, 2022By 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 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Associates of Georgia, LLCGroup PAC ID 3678547569, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: kiley.parrish.p1@direct.dermga.nextgenshare.com

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.

• Dermatology Associates of Georgia, LLC

  • Specialist
  • Decatur, GA
  • NPI 1063560803
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1645660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1235885666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 GREENWOOD AVE NE APT 6",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303063841",
            "telephone_number": "631-965-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MICHAEL ETCHISON RD",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306555996",
            "telephone_number": "770-476-7656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRISH",
        "first_name": "KILEY",
        "middle_name": "JORDAN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-24",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11043",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angie Pagano, D.O.
• Park Dental Group (Monroe Smile Center)
• Hyun W Park, DDS
• Parker Dialysis LLC (Walton County Dialysis)
• Danielle Parks
• Anita Sims Parsons, R. PH.
• Jenna Parsons, CPNP-PC
• Larry Paul Parworth, D.D.S., M.S.
• Patricia Pass-Dudley, D.D.S.
• Anvi Prakash Patel

• Physician Assistant in Monroe, GA
• Providers in Monroe, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.