Kaci Absalom, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-111962 Issued in AL

Practice address

5009 Riverchase Dr Ste 500
Phenix City, AL 36867-7490

Phone

(334) 448-9505

Fax

(334) 448-9575

NPI assigned

Dec 10, 2012

Last updated

Feb 14, 2018By the provider in NPPES

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 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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.

• Benning Hospitalist Services, LLC

  • Hospitalist Physician
  • Columbus, GA
  • NPI 1215442173
  Medicare reassignment NPD
• Muscogee Hospitalist Services, LLC

  • Hospitalist Physician
  • Columbus, GA
  • NPI 1639681851
  Medicare reassignment NPD

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

{
    "created_epoch": "1355097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518566400000",
    "number": "1639414188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5009 RIVERCHASE DR STE 500",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368677490",
            "telephone_number": "334-448-9505",
            "fax_number": "334-448-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5009 RIVERCHASE DR STE 500",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368677490",
            "telephone_number": "334-448-9505",
            "fax_number": "334-448-9575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABSALOM",
        "first_name": "KACI",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-10",
        "last_updated": "2018-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN177275",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-111962",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167806",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003138582",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• 1 On 1 Staffing and Wellness Clinic (1 on 1 Wellness Clinic)
• Lashawnda Adams
• Adaptive Family Services, LLC
• Lateisha Renee Adeola
• Admirable Home Care LLC
• Asia Adonis, MSW

• Family Nurse Practitioner in Phenix City, AL
• Providers in Phenix City, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.