Active NPI
Kellie Hibbitts, AUD
- Audiologist
- Riverdale, GA
National Provider Identifier
1407916463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 3744
- Practice address
- 181 Upper Riverdale Rd SW
Suite A1
Riverdale, GA 30274-4919 - Phone
- (770) 996-2861
- Fax
- (770) 991-1604
- NPI assigned
- Dec 11, 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 3744 | GA | Primary |
Addresses
Primary practice location
181 Upper Riverdale Rd SW
Suite A1
Riverdale, GA 30274-4919
Mailing address
181 Upper Riverdale Rd SW
Suite A1
Riverdale, GA 30274-4919
Phone (770) 996-2861
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3744 | GA | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Hearing Centers | Audiologist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Audiologist
- Riverdale, GA
- NPI 1912190661
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407916463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "181 UPPER RIVERDALE RD SW",
"address_2": "SUITE A1",
"city": "RIVERDALE",
"state": "GA",
"postal_code": "302744919",
"telephone_number": "770-996-2861",
"fax_number": "770-991-1604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "181 UPPER RIVERDALE RD SW",
"address_2": "SUITE A1",
"city": "RIVERDALE",
"state": "GA",
"postal_code": "302744919",
"telephone_number": "770-996-2861",
"fax_number": "770-991-1604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIBBITTS",
"first_name": "KELLIE",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "GA",
"license": "3744",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverdale, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.