Individual provider Active NPI

Kisha Lafleur, MD

  • Family Medicine Physician
  • Carrollton, GA
National Provider Identifier
1295357846
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
97261 Issued in GA
Practice address
706 Dixie St Ste 350
Carrollton, GA 30117-3860
Phone
(770) 812-5831
Fax
(770) 812-5832
NPI assigned
May 16, 2020
Last updated
Dec 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 97261 GA Primary

Addresses

Primary practice location

706 Dixie St Ste 350
Carrollton, GA 30117-3860

Mailing address

706 Dixie St Ste 350
Carrollton, GA 30117-3860
Phone (770) 812-5831

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230926002259 GA Practitioner - Family Practice 3678927530 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

706 Dixie St
Suite 350
Carrollton, GA 30117-3819
Phone (770) 812-5831

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Medical Group Inc Family Medicine CurrentSince Sep 18, 2023 Accepting new patients
TMC Children's Healthcare of West Georgia Past Accepting new patients

Locations

706 Dixie St
Ste 220
Carrollton, GA 30117
Phone (770) 812-8825

706 Dixie St
Ste 350
Carrollton, GA 30117
Phone (770) 812-5831

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1589587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1295357846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 DIXIE ST STE 350",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173860",
            "telephone_number": "770-812-5831",
            "fax_number": "770-812-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 DIXIE ST STE 350",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173860",
            "telephone_number": "770-812-5831",
            "fax_number": "770-812-5832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAFLEUR",
        "first_name": "KISHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-16",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "97261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.