Individual provider Active NPI

Kandelorea Starr Pierce, APRN, NP-C

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1679056543
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AC004079 Issued in MD
Practice address
1150 Hammond Dr Ste 310
Atlanta, GA 30328-7500
Phone
(678) 802-5780
NPI assigned
Sep 7, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN242669 GA
Family Nurse Practitioner 363LF0000X RN242669 GA
Family Nurse Practitioner 363LF0000X APRN11021197 FL
Family Nurse Practitioner 363LF0000X AC004079 MD Primary

Addresses

Primary practice location

1150 Hammond Dr Ste 310
Atlanta, GA 30328-7500

Mailing address

4300 N Point Pkwy Ste 300
Alpharetta, GA 30022-4102
Phone (770) 442-1911

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240521001701 GA Practitioner - Nurse Practitioner 4688016777 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN242669GAMDNurse Practitioner
APRN11021197FLMDFamily Nurse Practitioner
AC004079MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Group, P.C. CurrentSince Jun 1, 2024 Accepting new patients
Community Care Health Network LLC Nurse Practitioner CurrentSince Nov 1, 2025 Accepting new patients
Physician First Health Network PastSince Jun 3, 2025 Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

1000 Parkwood Cir SE
Ste 900
Atlanta, GA 30339
Phone (216) 393-8684

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

4300 Northpoint Pkwy
Ste 300
Johns Creek, GA 30022
Phone (770) 518-4406

1150 Hammond Dr
Ste 310
Sandy Springs, GA 30328
Phone (678) 802-5780

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1536278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1679056543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 N POINT PKWY STE 300",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300224102",
            "telephone_number": "770-442-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 HAMMOND DR STE 310",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303287500",
            "telephone_number": "678-802-5780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERCE",
        "first_name": "KANDELOREA",
        "middle_name": "STARR",
        "credential": "APRN, NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-07",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN242669",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN242669",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11021197",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "AC004079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.