Individual provider Active NPI

Keona Hollis, RN

  • Nurse Massage Therapist (NMT)
  • Decatur, GA
National Provider Identifier
1669379582
Registry record updated Oct 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse Massage Therapist (NMT)Taxonomy code 163WM1400X
License
RN317510 Issued in GA
Practice address
1670 Clairmont Rd
Decatur, GA 30033-4004
Phone
(404) 321-6111
NPI assigned
Oct 23, 2026
Last updated
Oct 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Massage Therapist (NMT) 163WM1400X RN317510 GA Primary

Addresses

Primary practice location

1670 Clairmont Rd
Decatur, GA 30033-4004

Mailing address

161 Watkins Glen Dr
McDonough, GA 30252-4085
Phone (404) 513-0031

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

NPI Registry JSON

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

{
    "created_epoch": "1792713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792713600000",
    "number": "1669379582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 WATKINS GLEN DR",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302524085",
            "telephone_number": "404-513-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 CLAIRMONT RD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300334004",
            "telephone_number": "404-321-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIS",
        "first_name": "KEONA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-23",
        "last_updated": "2026-10-23",
        "certification_date": "2026-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM1400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nurse Massage Therapist (NMT)",
            "state": "GA",
            "license": "RN317510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2026; 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.