Pamella Petrina Charles-Pryce, MD

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

05B155 Issued in GA

Practice address

3650 Steve Reynolds Blvd
Kaiser Permanente Gwinnett Medical Center
Duluth, GA 30096-4506

Phone

(770) 931-6012

Fax

(770) 806-1383

NPI assigned

Aug 7, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Family Practice

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• The Southeast Permanente Medical Group

  • Internal Medicine Physician
  • Atlanta, GA
  • NPI 1245266956
  Medicare reassignment Care Compare group NPD
• A & a Family Medical

  • Primary Care Clinic/Center
  • Grayson, GA
  • NPI 1598172769
  NPD (past) Authorized official
• Gwinnett Clinic LTD

  • Multi-Specialty Clinic/Center
  • Duluth, GA
  • NPI 1629117650

  Legal Medicine

  NPD (past)
• Gwinnett Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Tucker, GA
  • NPI 1013085513

  Legal Medicine

  NPD (past)
• Gwinnett Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Lilburn, GA
  • NPI 1063422277

  Legal Medicine

  NPD (past)
• Gwinnett Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Snellville, GA
  • NPI 1073524559

  Legal Medicine

  NPD (past)
• Gwinnett Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Lawrenceville, GA
  • NPI 1134132921

  Legal Medicine

  NPD (past)
• Gwinnett Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Lawrenceville, GA
  • NPI 1215005715

  Legal Medicine

  NPD (past)
• Gwinnett Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Loganville, GA
  • NPI 1255342630

  Legal Medicine

  NPD (past)
• Gwinnett Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Buford, GA
  • NPI 1346251733

  Legal Medicine

  NPD (past)
• Gwinnett Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Monroe, GA
  • NPI 1366453771

  Legal Medicine

  NPD (past)
• Gwinnett Clinic, LTD

  • Multi-Specialty Clinic/Center
  • Duluth, GA
  • NPI 1386750701

  Legal Medicine

  NPD (past)

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1629087465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT RD NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051717",
            "telephone_number": "404-364-7070",
            "fax_number": "770-806-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 STEVE REYNOLDS BLVD",
            "address_2": "KAISER PERMANENTE GWINNETT MEDICAL CENTER",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964506",
            "telephone_number": "770-931-6012",
            "fax_number": "770-806-1383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES-PRYCE",
        "first_name": "PAMELLA",
        "middle_name": "PETRINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "GA",
            "license": "058155",
            "primary": false
        },
        {
            "code": "173000000X",
            "taxonomy_group": "",
            "desc": "Legal Medicine",
            "state": "GA",
            "license": "05B155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "220156218",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3650 Steve Reynolds Blvd",
            "city": "Duluth",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300964506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Seong Kil Chang, DC
• Chante Wellington Mitchell, PH.D., LLC
• Silas Benjamin Chaplik
• Bridget Chappell
• Garrett Charette, DMD
• Scarlet Adana Chatman, NCC LPC
• Chattahoochee Gynecology PC
• Jagruti Chaudhari, PMHNP
• Biswashree Chaudhury, M.D.
• Christine Chauncey, ED.D, CCC-SLP

• Legal Medicine in Duluth, GA
• Providers in Duluth, GA by specialty
• Legal Medicine in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.