NPIMap

Organization Active NPI

Kelly Lynn Carson M.D.

  • Gastroenterology Physician
  • Atlanta, GA
National Provider Identifier
1649457441
Registry record updated Jan 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
055395 Issued in GA
Legal business name
KELLY LYNN CARSON M.D.
Practice address
5669 Peachtree Dunwoody Rd NE
Suite 210
Atlanta, GA 30342-1786
Phone
(404) 255-4333
Fax
(404) 255-0601
NPI assigned
Jan 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2008

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

Authorized official

Name
Kelly Lynn Carson, M.D.NPI 1801859327
Title
Owner
Phone
(404) 255-4333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 055395 GA Primary

Addresses

Primary practice location

5669 Peachtree Dunwoody Rd NE
Suite 210
Atlanta, GA 30342-1786

Mailing address

5669 Peachtree Dunwoody Rd NE
Suite 210
Atlanta, GA 30342-1786
Phone (404) 255-4333

National Provider Directory

National Provider Directory

Locations

5669 Ptree Dunwoody Rd NE
Ste 210
Sandy Springs, GA 30342
Phone (404) 255-4333

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201132800000",
    "number": "1649457441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5669 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421786",
            "telephone_number": "404-255-4333",
            "fax_number": "404-255-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5669 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421786",
            "telephone_number": "404-255-4333",
            "fax_number": "404-255-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY LYNN CARSON M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-24",
        "last_updated": "2008-01-24",
        "status": "A",
        "authorized_official_last_name": "CARSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-255-4333",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "055395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2008; 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.