NPIMap

Organization Active NPI

Cecelia Patrice Kane MDPC

  • Psychiatry Physician
  • Conyers, GA
National Provider Identifier
1255410049
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
037581 Issued in GA
Legal business name
CECELIA PATRICE KANE MDPC
Practice address
2215 Exchange Place
Suite B
Conyers, GA 30013-6723
Phone
(770) 761-8800
Fax
(770) 761-8435
NPI assigned
Nov 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Cecelia Patrice Kane, MDNPI 1841593928
Title
President of Corporation
Phone
(770) 761-8800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X 037581 GA Primary

Addresses

Primary practice location

2215 Exchange Place
Suite B
Conyers, GA 30013-6723

Mailing address

2215 Exchange Place
Suite B
Conyers, GA 30013-6723
Phone (770) 761-8800

Other names 1

  • Professional Corporation Other name

National Provider Directory

National Provider Directory

Locations

2215 Exchange Pl SE
#B
Conyers, GA 30013
Phone (770) 679-5294

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255410049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 EXCHANGE PLACE",
            "address_2": "SUITE B",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136723",
            "telephone_number": "770-761-8800",
            "fax_number": "770-761-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 EXCHANGE PLACE",
            "address_2": "SUITE B",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136723",
            "telephone_number": "770-761-8800",
            "fax_number": "770-761-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CECELIA PATRICE KANE MDPC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KANE",
        "authorized_official_first_name": "CECELIA",
        "authorized_official_middle_name": "PATRICE",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "770-761-8800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "037581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Corporation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.

Verify at the official NPI Registry.