Individual provider Active NPI

Korinne McNally

  • Registered Nurse
  • Decatur, GA
National Provider Identifier
1265259253
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN248844 Issued in GA
Practice address
125 Clairemont Ave Ste 190
Decatur, GA 30030-2585
Phone
(404) 748-9691
NPI assigned
Sep 23, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN248844 GA Primary

Addresses

Primary practice location

125 Clairemont Ave Ste 190
Decatur, GA 30030-2585

Mailing address

2356 Desmond Dr
Decatur, GA 30033-4745
Phone (770) 617-0008

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

LicenseStateTypeSpecialty
RN248844GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Childfren'S Medical Group, P.C. PastSince Sep 29, 2024 Accepting new patients
Edward M. Gotlieb, M.D., Et Al Dba the Pediatric Center PastSince Sep 29, 2024 Accepting new patients

Organizations & group practices 2

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": "1727049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1265259253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2356 DESMOND DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334745",
            "telephone_number": "770-617-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CLAIREMONT AVE STE 190",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302585",
            "telephone_number": "404-748-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNALLY",
        "first_name": "KORINNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-23",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN248844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; 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.