NPIMap

Organization Active NPI

Kaiser Foundation Health Plan of Georgia, Inc.

  • Managed Care Organization Pharmacy
  • Cumming, GA
National Provider Identifier
1447487574
Registry record updated Aug 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Managed Care Organization PharmacyTaxonomy code 3336M0003X
License
PHRE009584 Issued in GA
Legal business name
KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
Practice address
1400 Northside Forsyth Dr Ste 350
Cumming, GA 30041-6018
Phone
(404) 364-4824
Fax
(404) 949-5242
NPI assigned
Jun 16, 2009
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Diane Sanders
Title
Pharmacy Compliance Manager
Phone
(770) 712-5654

National Provider Directory

National Provider Directory
Tax ID family
Kaiser Foundation Health67 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1400 Northside Forsyth Dr
Ste 350
Cumming, GA 30041
Phone (404) 364-4824

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Managed Care Organization Pharmacy 3336M0003X PHRE009584 GA Primary

Addresses

NPPES NPI Registry

Primary practice location

1400 Northside Forsyth Dr Ste 350
Cumming, GA 30041-6018

Mailing address

1400 Northside Forsyth Dr Ste 350
Cumming, GA 30041-6018
Phone (404) 364-4824

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1158840OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

NPPES NPI Registry
  • Kaiser Permanente Forsyth Pharmacy Doing business as

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 4, 2021.

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628035200000",
    "number": "1447487574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 NORTHSIDE FORSYTH DR STE 350",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416018",
            "telephone_number": "404-364-4824",
            "fax_number": "404-949-5242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 NORTHSIDE FORSYTH DR STE 350",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416018",
            "telephone_number": "404-364-4824",
            "fax_number": "404-949-5242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-16",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "PHARMACY COMPLIANCE MANAGER",
        "authorized_official_telephone_number": "770-712-5654"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Managed Care Organization Pharmacy",
            "state": "GA",
            "license": "PHRE009584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1158840",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1400 Northside Forsyth Dr Ste 350",
            "city": "Cumming",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300416018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kaiser Permanente Forsyth Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaiser Permanente Forsyth Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.