Jerry Stephen Kroll, M.D.

Primary specialty

Pediatric Sports Medicine PhysicianTaxonomy code 2080S0010X

License

062735 Issued in GA

Practice address

5445 Meridian Marks Rd NE
Suite 250
Atlanta, GA 30342-4763

Phone

(404) 255-1933

Fax

(404) 256-7924

NPI assigned

Aug 20, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jkroll62197@choa.gadirect.net

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.

• Georgia Sports Medicine, LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Duluth, GA
  • NPI 1710160601
  NPD
• Children'S Orthopaedics of Atlanta P.C.

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1548247000
  NPD (past)
• Choa Hospital Based, LLC

  • Pediatrics Physician
  • Brookhaven, GA
  • NPI 1457695488
  NPD (past)
• The Longstreet Clinic PC

  • Prosthetic/Orthotic Supplier
  • Gainesville, GA
  • NPI 1053422428
  NPD (past)

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344297600000",
    "number": "1386837896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 MERIDIAN MARKS RD NE STE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424767",
            "telephone_number": "404-255-1933",
            "fax_number": "404-256-7924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5445 MERIDIAN MARKS RD NE",
            "address_2": "SUITE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424763",
            "telephone_number": "404-255-1933",
            "fax_number": "404-256-7924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROLL",
        "first_name": "JERRY",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-20",
        "last_updated": "2012-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080S0010X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sports Medicine",
            "state": "GA",
            "license": "062735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "686909673C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randall W Krizan, AA
• Julie Berryman Krochonis, NP
• Andrew Cameron Kroh, M.D.
• Benjamin Sydney Krohn, AA-C
• Edward Gerard Krolikowski, D.C.
• Emily Kroncke, M.ED., CCC-SLP
• Octavia Kronemberg, FNP-C
• Kaelyn Krook, MD
• Paulette Andrea Green Kropf, M.D.
• Zachary Kross, PA

• Pediatric Sports Medicine Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatric Sports Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.