Individual provider Active NPI

Kristina Jheanelle McCaw, MD

  • Internal Medicine Physician
  • Atlanta, GA
National Provider Identifier
1477931236
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
079271 Issued in GA
Practice address
720 Westview Drive, SW
Morehouse School of Medicine, Department of Internal Me
Atlanta, GA 30310
Phone
(404) 756-1325
Fax
(404) 756-1313
NPI assigned
May 13, 2015
Reactivated
Dec 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 079271 GA Primary

Addresses

Primary practice location

720 Westview Drive, SW
Morehouse School of Medicine, Department of Internal Me
Atlanta, GA 30310

Mailing address

720 Westview Drive, SW
Morehouse School of Medicine, Department of Internal Me
Atlanta, GA 30310
Phone (404) 756-1325

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181114003437 GA Practitioner - Hospitalist 0648572990 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
98.79 of 100Reported as group
Quality
98.74
Improvement activities
40
Cost
83.11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
079271GAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anemonefish Inpatient Services LLC Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Cogent Healthcare of Georgia PC Internal Medicine CurrentSince Aug 12, 2018 Accepting new patients
North Atlanta Professional Services LLC CurrentSince Sep 1, 2022 Accepting new patients

Locations

5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340

1170 Cleveland Ave
East Point, GA 30344
Phone (404) 305-3500

367 Clear Creek Pkwy
Lavonia, GA 30553
Phone (706) 356-7800

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

Organizations & group practices 3

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": "1431475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1477931236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WESTVIEW DRIVE, SW",
            "address_2": "MOREHOUSE SCHOOL OF MEDICINE, DEPARTMENT OF INTERNAL ME",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30310",
            "telephone_number": "404-756-1325",
            "fax_number": "404-756-1313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WESTVIEW DRIVE, SW",
            "address_2": "MOREHOUSE SCHOOL OF MEDICINE, DEPARTMENT OF INTERNAL ME",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30310",
            "telephone_number": "404-756-1325",
            "fax_number": "404-756-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCAW",
        "first_name": "KRISTINA",
        "middle_name": "JHEANELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-13",
        "last_updated": "2019-09-03",
        "deactivation_date": "2015-12-21",
        "reactivation_date": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "079271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.