NPIMap

Individual provider Active NPI

Kerry A Neises, MD

  • Family Medicine Physician
  • Dalton, GA
National Provider Identifier
1689671372
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
43720 Issued in GA
Practice address
914 Vista Drive
Dalton, GA 30721-8654
Phone
(706) 226-3139
Fax
(706) 278-6606
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 43720 GA Primary

Addresses

Primary practice location

914 Vista Drive
Dalton, GA 30721-8654

Mailing address

914 Vista Drive
Dalton, GA 30721-8654
Phone (706) 226-3139

Other identifiers 1

IdentifierTypeStateIssuer
000755532BMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100225000292 GA Practitioner - Family Practice 7416099726 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cornerstone Medical GroupGroup PAC ID 3971575390, 6 clinicians

Practice addresses (Care Compare)

914 Vista Dr
Dalton, GA 30721-8654

Hospital & facility affiliations

  • North Georgia Home Health Agency, an Amedysis Comp Home health agency, Ringgold, GA, CCN 117028
  • Hamilton Home Health Home health agency, Dalton, GA, CCN 117062
  • Hamilton Medical Center Hospital, Dalton, GA, CCN 110001
  • Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision11
Removal of skin lesions36
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Medical Center, Inc. CurrentSince Dec 1, 2016 Accepting new patients
Cornerstone Medical Group Family Medicine CurrentSince Oct 13, 1997 Accepting new patients
Hamilton Physician Group Inc CurrentSince Dec 1, 2016 Accepting new patients
Memorial Health Partners Foundation Inc Family Medicine Current Accepting new patients

Locations

914 Vista Dr
Dalton, GA 30721
Phone (706) 226-3139

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

1107 Memorial Dr
Ste 300
Dalton, GA 30720
Phone (706) 226-3139

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.401
  • Direct secure messaging: kerryneises@tnmhpf.allscriptsdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1689671372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 VISTA DRIVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307218654",
            "telephone_number": "706-226-3139",
            "fax_number": "706-278-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 VISTA DRIVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307218654",
            "telephone_number": "706-226-3139",
            "fax_number": "706-278-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEISES",
        "first_name": "KERRY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "43720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000755532B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.