Individual provider Active NPI

Katherine E Fleming-Dutra, M.D.

  • Pediatrics Physician
  • Atlanta, GA
National Provider Identifier
1548447477
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5964 Issued in GA
Practice address
1645 Tullie Cir NE
Atlanta, GA 30329-2304
Phone
(404) 785-7142
NPI assigned
Jan 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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 2007017952 MO
Pediatrics Physician 208000000X 2009010529 MO
Pediatrics Physician 208000000X 5964 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) 785-7142

Other names 1

  • Katherine E Fleming Former name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190212001764 GA Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 5991094419 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5964GAMDPediatrics Physician
2007017952MOMDPediatrics Physician
2009010529MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Medical Care Foundation Inc Current Accepting new patients
Emory Medical Care Foundation Inc CurrentSince Dec 5, 2018 Accepting new patients
Emory Medical Care Foundation Inc Pediatrics CurrentSince Dec 5, 2018 Accepting new patients

Locations

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

35 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 785-9500

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

Interoperability endpoints

  • Direct secure messaging: kflemingdutra61041@choa.gadirect.net

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": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350345600000",
    "number": "1548447477",
    "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": "404-785-7142"
        },
        {
            "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": "404-785-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEMING-DUTRA",
        "first_name": "KATHERINE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-22",
        "last_updated": "2012-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2007017952",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2009010529",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "5964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "FLEMING",
            "middle_name": "E",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.