Active NPI
Candice Kalin, CCP
- Perfusionist
- Marietta, GA
National Provider Identifier
1245835552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Perfusionist
- License
- 131
- Practice address
- Wellstar Kennestone Regional Medical Center
677 Church St.
Marietta, GA 30060 - Phone
- (770) 793-9466
- NPI assigned
- Dec 3, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Perfusionist | 242T00000X | 131 | GA | Primary |
Addresses
Primary practice location
Wellstar Kennestone Regional Medical Center
677 Church St.
Marietta, GA 30060
Mailing address
Wellstar Kennestone Regional Medical Center
677 Church St.
Marietta, GA 30060
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 131 | GA | MD | Prosthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606953600000",
"number": "1245835552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "WELLSTAR KENNESTONE REGIONAL MEDICAL CENTER",
"address_2": "677 CHURCH ST.",
"city": "MARIETTA",
"state": "GA",
"postal_code": "30060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "WELLSTAR KENNESTONE REGIONAL MEDICAL CENTER",
"address_2": "677 CHURCH ST.",
"city": "MARIETTA",
"state": "GA",
"postal_code": "30060",
"telephone_number": "770-793-9466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALIN",
"first_name": "CANDICE",
"credential": "CCP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-12-03",
"last_updated": "2020-12-03",
"certification_date": "2020-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "242T00000X",
"taxonomy_group": "",
"desc": "Perfusionist",
"state": "GA",
"license": "131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.