Individual provider Active NPI

Catherine Keith, NP

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1760501803
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R075194 Issued in GA
Practice address
993 Johnson Ferry Road NE, BLDG F
Suite 210
Atlanta, GA 30342-1620
Phone
(404) 256-1727
Fax
(404) 256-0192
NPI assigned
Mar 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R075194 GA Primary

Addresses

Primary practice location

993 Johnson Ferry Road NE, BLDG F
Suite 210
Atlanta, GA 30342-1620

Mailing address

993 Johnson Ferry Road NE, BLDG F
Suite 210
Atlanta, GA 30342-1620
Phone (404) 256-1727

Other identifiers 1

IdentifierTypeStateIssuer
R075194OtherGALICENCE

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
I20240531001759 GA Order and Referring Only - Nurse Practitioner 0648612994

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R075194GAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760501803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "993 JOHNSON FERRY ROAD NE, BLDG F",
            "address_2": "SUITE 210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421620",
            "telephone_number": "404-256-1727",
            "fax_number": "404-256-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "993 JOHNSON FERRY ROAD NE, BLDG F",
            "address_2": "SUITE 210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421620",
            "telephone_number": "404-256-1727",
            "fax_number": "404-256-0192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "CATHERINE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "R075194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE",
            "identifier": "R075194",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.