Individual provider Active NPI

Kristin Ruth Smith, CPNP

  • Pediatric Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1427685866
Registry record updated Mar 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN255196 Issued in GA
Practice address
980 Johnson Fy Rd NE Ste 620
Atlanta, GA 30342-1608
Phone
(404) 252-9751
NPI assigned
Mar 25, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN255196 GA Primary

Addresses

Primary practice location

980 Johnson Fy Rd NE Ste 620
Atlanta, GA 30342-1608

Mailing address

980 Johnson Fy Rd NE Ste 620
Atlanta, GA 30342-1608
Phone (404) 252-9751

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251003003177 GA Practitioner - Nurse Practitioner 1456857861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1575 Northeast Expy NE
Brookhaven, GA 30329-2401

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN255196GAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Choa Hospital Based, LLC Pediatrics CurrentSince Jul 24, 2025 Accepting new patients
Choa Multispecialty, LLC Pediatrics Current Accepting new patients

Locations

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

2220 N Druid Hills Rd NE
Brookhaven, GA 30329
Phone (404) 778-1440

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1427685866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 JOHNSON FY RD NE STE 620",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421608",
            "telephone_number": "404-252-9751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 JOHNSON FY RD NE STE 620",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421608",
            "telephone_number": "404-252-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KRISTIN",
        "middle_name": "RUTH",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "RN255196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.