Individual provider Active NPI

Kimberly Lauren Norris, M.D.

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Atlanta, GA
National Provider Identifier
1528355880
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
78193 Issued in GA
Practice address
1645 Tullie Cir NE
Atlanta, GA 30329-2304
Phone
(404) 785-7141
NPI assigned
Jul 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2011015976 MO
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 9054833-1205 UT
Pediatric Emergency Medicine (Pediatrics) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0204X 78193 GA Primary

Addresses

Primary practice location

1645 Tullie Cir NE
Atlanta, GA 30329-2304

Mailing address

1645 Tullie Cir NE
Atlanta, GA 30329-2304
Phone (404) 785-7141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150128000090 UT Practitioner - Pediatric Medicine 9234356882
I20170925002428 GA Practitioner - Pediatric Medicine 9234356882 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011015976MOMDPediatrics Physician
78193GAMDPediatric Emergency Medicine (Pediatrics) Physician
9054833-1205UTMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Pediatrics CurrentSince Aug 21, 2017 Accepting new patients
Emory Medical Care Foundation Inc Single Specialty CurrentSince Aug 21, 2017 Accepting new patients
Emory Medical Care Foundation Inc Single Specialty Current Accepting new patients
Children'S Healthcare of Atlanta Single Specialty PastSince Jul 24, 2022 Accepting new patients

Locations

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

101 W Ponce de Leon Ave
Decatur, GA 30030
Phone (404) 778-4889

Organizations & group practices 4

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": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1528355880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 TULLIE CIR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292304",
            "telephone_number": "404-785-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 TULLIE CIR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292304",
            "telephone_number": "404-785-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORRIS",
        "first_name": "KIMBERLY",
        "middle_name": "LAUREN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2011015976",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "UT",
            "license": "9054833-1205",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "GA",
            "license": "78193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.