Individual provider Active NPI

Kiyatha General, CNA

  • Nurse's Aide
  • Covington, GA
National Provider Identifier
1336891597
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
CN0028904717 Issued in GA
Practice address
455 Freeman Dr
Covington, GA 30016-8958
Phone
(404) 781-3559
NPI assigned
Jan 19, 2022
Last updated
Jan 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X CN0028904717 GA Primary

Addresses

Primary practice location

455 Freeman Dr
Covington, GA 30016-8958

Mailing address

455 Freeman Dr
Covington, GA 30016-8958
Phone (404) 781-3559

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

LicenseStateTypeSpecialty
CN0028904717GAMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1336891597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 FREEMAN DR",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300168958",
            "telephone_number": "404-781-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 FREEMAN DR",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300168958",
            "telephone_number": "404-781-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENERAL",
        "first_name": "KIYATHA",
        "credential": "CNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-19",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "GA",
            "license": "CN0028904717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.