Active NPI
Kristen Healy, PA
- Physician Assistant
- Marietta, GA
National Provider Identifier
1386688943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 4883
- Practice address
- 1121 Johnson Ferry Rd
Suite 100
Marietta, GA 30068-5425 - Phone
- (770) 509-1025
- Fax
- (770) 509-1884
- NPI assigned
- Jun 15, 2006
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 4883 | GA | Primary |
Addresses
Primary practice location
1121 Johnson Ferry Rd
Suite 100
Marietta, GA 30068-5425
Mailing address
1121 Johnson Ferry Rd
Suite 100
Marietta, GA 30068-5425
Phone (770) 509-1025
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1668 | MA | MD | Behavioral Analyst |
| 4883 | GA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252886400000",
"number": "1386688943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1121 JOHNSON FERRY RD",
"address_2": "SUITE 100",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300685425",
"telephone_number": "770-509-1025",
"fax_number": "770-509-1884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1121 JOHNSON FERRY RD",
"address_2": "SUITE 100",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300685425",
"telephone_number": "770-509-1025",
"fax_number": "770-509-1884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEALY",
"first_name": "KRISTEN",
"name_prefix": "Mrs.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-15",
"last_updated": "2009-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "4883",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
- Healthy Collaborations LLC
- Healthy Smiles of East Cobb
- Healthy Solutions - the Chiropractic Wellness Center (Health Solutions)
- Healthy Steps Pediatrics, LLC
- Anna Rohan Healy, P.A.
- Lindsay Kathleen Healy, SLP
- Destini Elizabeth Kadijah Heard, BS
- Kamara Suzanne Heard, ACNP
- Shani Nicole Heard
- Vernisha Hearn, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.