Active NPI
Khrysta Alexander
- Community Health Worker
- Marietta, GA
National Provider Identifier
1740151455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- OCC041695
- Practice address
- 2060 Planters Mill LN
Marietta, GA 30062-4754 - Phone
- (404) 971-3441
- NPI assigned
- Sep 16, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | OCC041695 | GA | Primary |
Addresses
Primary practice location
2060 Planters Mill LN
Marietta, GA 30062-4754
Mailing address
2060 Planters Mill LN
Marietta, GA 30062-4754
Phone (404) 971-3441
Other names 1
- Jeanette Davis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OCC041695 | GA | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1757980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757980800000",
"number": "1740151455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2060 PLANTERS MILL LN",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300624754",
"telephone_number": "404-971-3441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2060 PLANTERS MILL LN",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300624754",
"telephone_number": "404-971-3441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALEXANDER",
"first_name": "KHRYSTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-09-16",
"last_updated": "2025-09-16",
"certification_date": "2025-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Community Health Worker",
"state": "GA",
"license": "OCC041695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JEANETTE",
"last_name": "DAVIS",
"credential": "RN",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.