Individual provider Active NPI

Kathryn M McMinn, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Austell, GA
National Provider Identifier
1508946526
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
46452 Issued in GA
Practice address
1664 Mulkey Rd
Austell, GA 30106
Phone
(770) 422-1372
Fax
(770) 999-2599
NPI assigned
Oct 16, 2006
Last updated
Oct 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 46452 GA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 46452 GA Primary

Addresses

Primary practice location

1664 Mulkey Rd
Austell, GA 30106

Mailing address

805 Sandy Plains Road
Medical Staff Services
Marietta, GA 30066-6340

Other practice location 1

55 Whitcher St NE
Suite 360
Marietta, GA 30060-1155
Phone (770) 422-1372

Other practice location 2

55 Whitcher St NE
Suite 360
Marietta, GA 30060-1155
Phone (770) 422-1372

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kmcminn39798@directwellstar.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
46452GAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Pulmonary Group, LLC Pulmonary Disease Past Accepting new patients
Critical Care Atlanta, LLC Critical Care Medicine Past Accepting new patients
Cardiovascular Group, PC Past Accepting new patients

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, 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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1508946526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 SANDY PLAINS ROAD",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1664 MULKEY RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "30106",
            "telephone_number": "770-422-1372",
            "fax_number": "770-999-2599"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Whitcher St NE",
            "address_2": "Suite 360",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300601155",
            "country_code": "US",
            "telephone_number": "770-422-1372",
            "fax_number": "770-423-9651",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Whitcher St NE",
            "address_2": "Suite 360",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300601155",
            "country_code": "US",
            "telephone_number": "770-422-1372",
            "fax_number": "770-423-9651",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMINN",
        "first_name": "KATHRYN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "GA",
            "license": "46452",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "GA",
            "license": "46452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmcminn39798@directwellstar.org",
            "affiliation": "N",
            "address_1": "1664 Mulkey Rd",
            "city": "Austell",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301061114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.