Individual provider Active NPI

Kellie Anne Coyle, M.D.

  • Specialist
  • Sandy Springs, GA
National Provider Identifier
1336174499
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
033060 Issued in GA
Practice address
20 Glenlake Pkwy
Sandy Springs, GA 30328-3431
Phone
(404) 299-6488
Fax
(404) 299-7522
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 033060 GA Primary

Addresses

Primary practice location

20 Glenlake Pkwy
Sandy Springs, GA 30328-3431

Mailing address

2454 Oakleigh CT NE
Atlanta, GA 30345-3874
Phone (404) 365-0096

Other identifiers 1

IdentifierTypeStateIssuer
00653045BMedicaidGA

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
I20060505000553 GA Practitioner - Vascular Surgery 5698786655 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tranquil Anesthesiology LLC CurrentSince Aug 1, 2022 Accepting new patients
Milner Vein and Vascular LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

5700 Hillandale Dr
Ste 120
Lithonia, GA 30058
Phone (678) 580-1149

1462 Montreal Rd
Ste 201
Tucker, GA 30084
Phone (770) 414-5611

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DAFHCD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1336174499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2454 OAKLEIGH CT NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303453874",
            "telephone_number": "404-365-0096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 GLENLAKE PKWY",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303283431",
            "telephone_number": "404-299-6488",
            "fax_number": "404-299-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYLE",
        "first_name": "KELLIE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "033060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00653045B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy Springs, GA

Sources for this page

Verify at the official NPI Registry.