Active NPI
Niekquan Kobe Gadson
- Private Vehicle
- Kennesaw, GA
National Provider Identifier
1275339657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- License
- 058138891
- Practice address
- 1635 S Hood CT NW
Kennesaw, GA 30152-4358 - Phone
- (404) 434-6324
- NPI assigned
- Feb 25, 2025
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | 058138891 | GA | Primary |
Addresses
Primary practice location
1635 S Hood CT NW
Kennesaw, GA 30152-4358
Mailing address
1635 S Hood CT NW
Kennesaw, GA 30152-4358
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 |
|---|---|---|---|
| 058138891 | GA | MD | Private Vehicle |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740441600000",
"number": "1275339657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1635 S HOOD CT NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301524358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 S HOOD CT NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301524358",
"telephone_number": "404-434-6324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GADSON",
"first_name": "NIEKQUAN",
"middle_name": "KOBE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-02-25",
"last_updated": "2025-02-25",
"certification_date": "2025-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "GA",
"license": "058138891",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.