Active NPI
Renee S King, FNP-C
- Nurse Practitioner
- Peachtree City, GA
National Provider Identifier
1376858555
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN115077
- Practice address
- 4000 Shakerag HL
301
Peachtree City, GA 30269-4047 - Phone
- (770) 486-7192
- Fax
- (770) 486-7110
- NPI assigned
- Aug 12, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN115077 | GA | Primary |
Addresses
Primary practice location
4000 Shakerag HL
301
Peachtree City, GA 30269-4047
Mailing address
PO Box 102321
Atlanta, GA 30368-2321
Phone (770) 333-8788
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)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281657600000",
"number": "1376858555",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 102321",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303682321",
"telephone_number": "770-333-8788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 SHAKERAG HL",
"address_2": "301",
"city": "PEACHTREE CITY",
"state": "GA",
"postal_code": "302694047",
"telephone_number": "770-486-7192",
"fax_number": "770-486-7110"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "RENEE",
"middle_name": "S",
"name_prefix": "Mrs.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-12",
"last_updated": "2010-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "RN115077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peachtree City, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.