Individual provider Active NPI

Kymberly Elrod Rizoti, NP

  • Nurse Practitioner
  • Canton, GA
National Provider Identifier
1740066786
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN286165 Issued in GA
Practice address
460 Northside Cherokee Blvd Ste 410
Canton, GA 30115-8023
Phone
(678) 786-7430
Fax
(678) 786-7431
NPI assigned
Sep 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN286165 GA Primary

Addresses

Primary practice location

460 Northside Cherokee Blvd Ste 410
Canton, GA 30115-8023

Mailing address

277 Arbor Hills Rd S
Talking Rock, GA 30175-4191
Phone (678) 602-3554

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
I20231005002425 GA Practitioner - Nurse Practitioner 1456706738 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

460 Northside Cherokee
Suite 410
Canton, GA 30115-8016
Phone (678) 786-7430

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern ENT Specialists, LLC CurrentSince Dec 19, 2023 Accepting new patients
Northside Surgical Professional Services LLC CurrentSince Sep 25, 2023 Accepting new patients

Locations

460 Northside Cherokee Blvd
Ste 410
Canton, GA 30115
Phone (470) 242-0730

684 Sixes Rd
Ste 220
Holly Springs, GA 30115
Phone (678) 313-5914

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

Interoperability endpoints

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

Organizations & group practices 2

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": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1740066786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 ARBOR HILLS RD S",
            "city": "TALKING ROCK",
            "state": "GA",
            "postal_code": "301754191",
            "telephone_number": "678-602-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 NORTHSIDE CHEROKEE BLVD STE 410",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301158023",
            "telephone_number": "678-786-7430",
            "fax_number": "678-786-7431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZOTI",
        "first_name": "KYMBERLY",
        "middle_name": "ELROD",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN286165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.