Kristin Sue Anderson-Taylor, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

6019 Issued in GA

Practice address

411 Orchard Hill Rd
Summerville, GA 30747-6548

Phone

(706) 978-9991

NPI assigned

Dec 11, 2006

Last updated

Sep 13, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Kristin Sue Anderson-Taylor Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1396805529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 ORCHARD HILL RD",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307476548",
            "telephone_number": "706-978-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 ORCHARD HILL RD",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "307476548",
            "telephone_number": "706-978-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON-TAYLOR",
        "first_name": "KRISTIN",
        "middle_name": "SUE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601002268",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "022313",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "6019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396805529",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1396805529",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "ANDERSON-TAYLOR",
            "middle_name": "SUE",
            "credential": "TAYLOR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Adventist Health System Georgia Inc (AdventHealth Summerville Clinic)
• James Allie, PT
• Amedisys Georgia LLC (North Georgia Home Health Agency an Amedisys Company)
• Jeff M Appelbaum, D.C.
• Linda Reeves Ballenger, L.D.O.
• Aimee Barron
• Big B Drugs Inc (CVS Pharmacy)
• Bio-Medical Applications of Georgia, Inc. (Fresenius Kidney Care Chattooga County)

• Medical Physician Assistant in Summerville, GA
• Providers in Summerville, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.