Individual provider Active NPI

Sallyann Mederer Coleman King, MD, MSC

  • Public Health & General Preventive Medicine Physician
  • Atlanta, GA
National Provider Identifier
1659556702
Registry record updated Jan 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
002046 Issued in GA
Practice address
49 Jesse Hill Jr Dr
Emory University Depart of Family and Preventive Med
Atlanta, GA 30303
Phone
(404) 616-5604
NPI assigned
Jan 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X 002046 GA Primary

Addresses

Primary practice location

49 Jesse Hill Jr Dr
Emory University Depart of Family and Preventive Med
Atlanta, GA 30303

Mailing address

2454 Woodridge Dr
Decatur, GA 30033-4830
Phone (404) 248-9725

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
002046GAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199750400000",
    "number": "1659556702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2454 WOODRIDGE DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334830",
            "telephone_number": "404-248-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 JESSE HILL JR DR",
            "address_2": "EMORY UNIVERSITY DEPART OF FAMILY AND PREVENTIVE MED",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30303",
            "telephone_number": "404-616-5604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN KING",
        "first_name": "SALLYANN",
        "middle_name": "MEDERER",
        "name_prefix": "Dr.",
        "credential": "MD, MSC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-08",
        "last_updated": "2008-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "GA",
            "license": "002046",
            "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 8, 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.