Individual provider Active NPI

Merlyn J Kaalla, D.O.

  • Family Medicine Physician
  • Conyers, GA
National Provider Identifier
1316470594
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
85473 Issued in GA
Practice address
1765 Parker Rd SE Ste B240
Conyers, GA 30094-6673
Phone
(770) 602-2970
NPI assigned
Apr 5, 2017
Last updated
Sep 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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 85473 GA Primary

Addresses

Primary practice location

1765 Parker Rd SE Ste B240
Conyers, GA 30094-6673

Mailing address

4302 Pond Edge Rd
Snellville, GA 30039-3971

Other practice location 1

777 Hemlock St, MSC 165
The Medical Center, Navicent Health
Macon, GA 31201
Phone (404) 422-7560

Other practice location 2

4250 Brownsville Rd
Powder Springs, GA 30127-2559
Phone (678) 567-8000

Other practice location 3

3780 Eisenhower PKWY
Macon, GA 31206
Phone (478) 633-5550

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkaalla407345@directwellstar.org Health Information Exchange (HIE)

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
I20210202003210 GA Practitioner - Family Practice 2365793916 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

105 Collier Rd NW
Suite 5020
Atlanta, GA 30309-1731
Phone (404) 367-3210

1765 Parker Rd SE
Suite B240
Conyers, GA 30094-6673
Phone (678) 609-6282

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Feb 1, 2021 Accepting new patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients
Piedmont Medical Care Corporation Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
The Medical Center of Central Georgia Inc Past Accepting new patients
Health Services of Central Georgia, Inc Family Medicine PastSince Aug 1, 2013 Accepting new patients
Piedmont Providers LLC Past Accepting new patients

Locations

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

1765 Parker Rd SE
Ste B240
Conyers, GA 30094
Phone (678) 609-6282

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

4250 Brownsville Rd
Powder Springs, GA 30127
Phone (678) 567-8000

Organizations & group practices 7

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 2

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": "1491350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1316470594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4302 POND EDGE RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300393971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 PARKER RD SE STE B240",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946673",
            "telephone_number": "770-602-2970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 Hemlock St, MSC 165",
            "address_2": "The Medical Center, Navicent Health",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "31201",
            "country_code": "US",
            "telephone_number": "404-422-7560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4250 Brownsville Rd",
            "address_purpose": "LOCATION",
            "city": "Powder Springs",
            "state": "GA",
            "postal_code": "301272559",
            "country_code": "US",
            "telephone_number": "678-567-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3780 Eisenhower PKWY",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "31206",
            "country_code": "US",
            "telephone_number": "478-633-5550",
            "fax_number": "478-633-7287",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAALLA",
        "first_name": "MERLYN",
        "middle_name": "J",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-05",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "85473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkaalla407345@directwellstar.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "4250 Brownsville Rd",
            "city": "Powder Springs",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301272559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.