Advanced Practice Telemedicine

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ADVANCED PRACTICE TELEMEDICINE

Practice address

361 17TH St NW Unit 718
Atlanta, GA 30363-1080

Phone

(478) 443-0964

NPI assigned

Jan 19, 2021

Last updated

May 1, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles E Kitchens, NP-CNPI 1366858680

Title

Business Owner

Phone

(478) 443-0964

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles Kitchens Jr.

  • Nurse Practitioner
  • Atlanta, GA
  • NPI 1366858680
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746057600000",
    "number": "1720678246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 17TH ST NW UNIT 718",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303631080",
            "telephone_number": "478-443-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 17TH ST NW UNIT 718",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303631080",
            "telephone_number": "478-443-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PRACTICE TELEMEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-19",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A",
        "authorized_official_last_name": "KITCHENS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "478-443-0964",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Advanced Sleep Laboratory-Dunwoody
• Advanced Sleep Tech of Ga
• Advanced Surgery Center Perimeter, LLC
• Advanced Therapy Group Inc.

• Multi-Specialty Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Multi-Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.