Kelly Brooks McGowan, CPNP-AC

Primary specialty

Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X

License

RN285784 Issued in GA

Practice address

1405 Clifton Rd NE FL 4
Atlanta, GA 30322-4052

Phone

(703) 609-9148

NPI assigned

Nov 15, 2019

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Choa Hospital Based, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1457695488

  Single Specialty

  Medicare reassignment NPD
• Choa Multispecialty, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1437493467

  Single Specialty

  NPD

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

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1275178915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7570 EASTON VALLEY LN",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300288976",
            "telephone_number": "703-609-9148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE FL 4",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303224052",
            "telephone_number": "703-609-9148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGOWAN",
        "first_name": "KELLY",
        "middle_name": "BROOKS",
        "credential": "CPNP-AC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-15",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN285784",
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "GA",
            "license": "RN285784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Thomas McGourk, PTA
• Alva S McGovern, MSW, LCSW
• Regan Elizabeth McGovern, PA
• Catherine Williams McGowan, RBT
• John E McGowan Jr., M.D.
• Viola McGowan, MS
• Alexis Nicole McGowin
• Jane McGrath
• Michael Wayne McGrath
• Candis McGraw-Senat, PHARMD

• Critical Care Pediatric Nurse Practitioner in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Critical Care Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.