Poonam Kumar

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN237126 Issued in GA

Practice address

6031 Fairburn Rd
Douglasville, GA 30134-2307

Phone

(770) 942-9214

NPI assigned

Aug 19, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Dynamic Urgent Care PC

  • Urgent Care Clinic/Center
  • Kennesaw, GA
  • NPI 1053050021
  NPD (past)
• Pedpost Foundation Inc

  • Health Service Clinic/Center
  • Alpharetta, GA
  • NPI 1821592593
  NPD (past)

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1689286882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6031 FAIRBURN RD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6031 FAIRBURN RD",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301342307",
            "telephone_number": "770-942-9214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "POONAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-19",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN237126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KTT Services
• Sierra Kucsera
• Kukaswadia P.C.
• Mohammad Ali Kukaswadia, MD
• Raju J Kulangara, MD
• Surender V Kumar, M.D.
• Veeni S Kumar, M.D.
• Lanalynne Ann Kurtzworth, RN
• Lana Kuykendoll
• Kynd Anesthesia, Inc

• Family Nurse Practitioner in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.