Individual provider Active NPI

Laurie Martin-Kiser, FNP

  • Family Nurse Practitioner
  • Royston, GA
National Provider Identifier
1497735328
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN135069 Issued in GA
Practice address
819 Church Street
Royston, GA 30662
Phone
(706) 245-6177
Fax
(706) 245-6242
NPI assigned
Jan 18, 2006
Last updated
Oct 20, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN135069 GA Primary

Addresses

Primary practice location

819 Church Street
Royston, GA 30662

Mailing address

819 Church Street
Royston, GA 30662
Phone (706) 245-6177

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
I20050331000686 GA Practitioner - Nurse Practitioner 0042267221 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN135069GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physiatry Consultants of Ga LLC CurrentSince Mar 1, 2021 Accepting new patients
Medical Director Services PC CurrentSince Aug 1, 2021 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

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1497735328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 CHURCH STREET",
            "city": "ROYSTON",
            "state": "GA",
            "postal_code": "30662",
            "telephone_number": "706-245-6177",
            "fax_number": "706-245-6242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 CHURCH STREET",
            "city": "ROYSTON",
            "state": "GA",
            "postal_code": "30662",
            "telephone_number": "706-245-6177",
            "fax_number": "706-245-6242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN-KISER",
        "first_name": "LAURIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN135069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royston, GA

Sources for this page

Verify at the official NPI Registry.