Georgia Psychiatry Services LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

GEORGIA PSYCHIATRY SERVICES LLC

Practice address

130 N Gross Rd
Kingsland, GA 31548-6262

Phone

(912) 208-2055

Fax

(912) 250-5813

NPI assigned

Feb 19, 2025

Organization subpart

No

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

Authorized official

Name

Ms. Kellie King, APRNNPI 1568946150

Title

Owner

Phone

(912) 223-2310

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kellie King, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Marys, GA
  • NPI 1568946150
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1739923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739923200000",
    "number": "1245036573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 EAGLE BLVD",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486495",
            "telephone_number": "912-223-2310",
            "fax_number": "912-250-5813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N GROSS RD",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486262",
            "telephone_number": "912-208-2055",
            "fax_number": "912-250-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA PSYCHIATRY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-19",
        "last_updated": "2025-02-19",
        "certification_date": "2025-02-19",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-223-2310",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003214783A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003214783B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nadine Guediri Funston, D.C.
• Gateway Behavioral Health Services
• Lisa Leanne Gentzler, M.P.T.
• Georgia CVS Pharmacy LLC
• Georgia Pain Physicians PC
• Mary Kathleen Giesbrecht, SLP
• GLL Center, LLC
• Golden Isles Pediatric Dentistry
• Kimberly Michelle Gomez, MSN, APRN, FNP-C
• Samantha Graf

• Psychiatric/Mental Health Nurse Practitioner in Kingsland, GA
• Providers in Kingsland, GA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.