Individual provider Active NPI

Katina Denise Ward, RN

  • Developmental - Behavioral Pediatrics Physician
  • Decatur, GA
National Provider Identifier
1376068668
Registry record updated Aug 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
RN165777 Issued in GA
Practice address
2591 Candler Rd
Decatur, GA 30032-6502
Phone
(678) 209-2710
Fax
(678) 212-6304
NPI assigned
Aug 7, 2017
Last updated
Aug 7, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental - Behavioral Pediatrics Physician 2080P0006X RN165777 GA Primary

Addresses

Primary practice location

2591 Candler Rd
Decatur, GA 30032-6502

Mailing address

3235 Wildflower Rd
Rex, GA 30273-2453
Phone (706) 992-5564

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN165777GAMDDevelopmental - Behavioral Pediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1502064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502064000000",
    "number": "1376068668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3235 WILDFLOWER RD",
            "city": "REX",
            "state": "GA",
            "postal_code": "302732453",
            "telephone_number": "706-992-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2591 CANDLER RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300326502",
            "telephone_number": "678-209-2710",
            "fax_number": "678-212-6304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARD",
        "first_name": "KATINA",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-07",
        "last_updated": "2017-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "GA",
            "license": "RN165777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2017; 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.