Active NPI
Joel Kevin Price, PA
- Physician Assistant
- Powder Springs, GA
National Provider Identifier
1649618570
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 002758
- Practice address
- 4039 Atlanta St
Powder Springs, GA 30127-2666 - Phone
- (770) 943-3139
- NPI assigned
- Jun 13, 2013
- Last updated
- Jun 13, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 002758 | GA | Primary |
Addresses
Primary practice location
4039 Atlanta St
Powder Springs, GA 30127-2666
Mailing address
4039 Atlanta St
Powder Springs, GA 30127-2666
Phone (770) 943-3139
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002758 | Other | GA | STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53865 | CA | MD | Dentist |
| 002758 | GA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371081600000",
"number": "1649618570",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4039 ATLANTA ST",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301272666",
"telephone_number": "770-943-3139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4039 ATLANTA ST",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301272666",
"telephone_number": "770-943-3139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRICE",
"first_name": "JOEL",
"middle_name": "KEVIN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-06-13",
"last_updated": "2013-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "002758",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "002758",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Powder Springs, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.