Laurie Martin-Kiser, FNP
Individual provider Active NPI Family Nurse Practitioner · Royston, GA
NPI 1497735328 · NPPES record last updated Oct 20, 2011
Key facts
- NPI
- 1497735328
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN135069 (GA)
- Practice address
- 819 Church Street
Royston, GA 30662 - Phone
- (706) 245-6177
- Fax
- (706) 245-6242
- NPI assigned
- Jan 18, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050331000686 | GA | Practitioner - Nurse Practitioner | 0042267221 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN135069 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Medical Director Services PC | Current |
Accepting new patients | |
| Physiatry Consultants of Ga LLC | Current |
Accepting new patients | |
| Vision Medical Consulting, P.C. | Past | Accepting new patients | |
| Athens-Clarke Emergency Specialists | Past | Accepting new patients | |
| Royston Medical Associates PC | Past | Accepting new patients |
Locations
2850 Springdale Rd SW
Atlanta, GA 30315
Phone (404) 616-8100
2117 Dr George Ward Rd
Elberton, GA 30635
Phone (706) 283-3335
3460 Powder Springs Rd
Powder Springs, GA 30127
Phone (770) 439-9199
415 W Golf Rd
Ste 26
Arlington Hts, IL 60005
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN135069 | GA | Yes |
Addresses
Primary practice location
819 Church Street
Royston, GA 30662
Mailing address
819 Church Street
Royston, GA 30662
Phone (706) 245-6177
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 741481598A | Medicaid | GA |
Other providers in Royston, GA
- Susan Kellum
- Victoria Lecroy
- Diane Veronica Lewis
- Gina Marie Looney
- Sahar Mahzoon
- Amber Maxwell
- Anna Grace McCurley
- Crystal Dawn Meadows
- Med Strip LLC
- Medlink Georgia Inc
All providers in Royston, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.