Kelly Grommersch Lynch, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN208756 Issued in GA

Practice address

3400C Old Milton Pkwy Ste 290
Alpharetta, GA 30005-4438

Phone

(770) 667-4343

Fax

(770) 772-0937

NPI assigned

Jul 30, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Interoperability endpoints

• Direct secure messaging: kelly.lynch@ppcp1.eclinicaldirectplus.com

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.

• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  NPD (past)

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520380800000",
    "number": "1295110310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "NORTHSIDE HOSPITAL - MANAGED CARE DEPARTMENT",
            "address_2": "1000 JOHNSON FERRY RD NE ATLANTA",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423034",
            "telephone_number": "404-851-8097",
            "fax_number": "404-250-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400C OLD MILTON PKWY STE 290",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054438",
            "telephone_number": "770-667-4343",
            "fax_number": "770-772-0937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "KELLY",
        "middle_name": "GROMMERSCH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2018-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "19544",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19544",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN208756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3344",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luxottica of America Inc
• Luxottica of America Inc.
• Luxottica of America Inc.
• Luxottica Retail North America Inc
• Luxottica Retail North America Inc
• Taylor Lyon, BCBA
• Stacy Lynn Lyons, OTR/L
• Ma Med Supply LLC
• Gabriella Mabayyed
• Jakkiyah Mack

• Family Nurse Practitioner in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; 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.