Active NPI
Paula Carr, M.D
- Family Medicine Physician
- Duluth, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 076664
- Practice address
- 3650 Steve Reynolds Blvd
Kaiser Permanente Gwinnett Medical Center
Duluth, GA 30096 - Phone
- (770) 931-6012
- NPI assigned
- Feb 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0101058937 | VA | |
| Family Medicine Physician | 207Q00000X | 076664 | GA | Primary |
Addresses
Primary practice location
3650 Steve Reynolds Blvd
Kaiser Permanente Gwinnett Medical Center
Duluth, GA 30096
Mailing address
3495 Piedmont Road, NE
Nine Piedmont Center
Atlanta, GA 30305
Phone (404) 504-5678
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 541595397 | Other | VA | VIRGINIA HEALTH NETWORK |
| 27575 | Other | VA | SENTARA/OPTIMA |
| 010211719 | Medicaid | VA | |
| 541595397 | Other | VA | VIRGINIA PREMIER |
| 4399936 | Other | VA | AETNA |
| 541595397035 | Other | VA | TRICARE |
| 183922 | Other | VA | ANTHEM |
Other names 1
- Paula Jubilee
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq | Health Information Exchange (HIE) |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Warren Alpert Medical School of Brown University, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3495 Piedmont Rd NE
Atlanta, GA 30305-1729
Phone (404) 364-7206
3650 Steve Reynolds Blvd
Duluth, GA 30096-4506
Phone (770) 931-6026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101058937 | VA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Southeast Permanente Medical Group | Family Medicine | Current | Accepting new patients |
Locations
3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000
3650 Steve Reynolds Blvd
Duluth, GA 30096
Phone (770) 931-6010
Organizations & group practices 1
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.
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1245266956
Family Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646611200000",
"number": "1801869193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3495 PIEDMONT ROAD, NE",
"address_2": "NINE PIEDMONT CENTER",
"city": "ATLANTA",
"state": "GA",
"postal_code": "30305",
"telephone_number": "404-504-5678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3650 STEVE REYNOLDS BLVD",
"address_2": "KAISER PERMANENTE GWINNETT MEDICAL CENTER",
"city": "DULUTH",
"state": "GA",
"postal_code": "30096",
"telephone_number": "770-931-6012"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARR",
"first_name": "PAULA",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-08",
"last_updated": "2022-03-07",
"certification_date": "2022-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "VA",
"license": "0101058937",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "GA",
"license": "076664",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA HEALTH NETWORK",
"identifier": "541595397",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SENTARA/OPTIMA",
"identifier": "27575",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010211719",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA PREMIER",
"identifier": "541595397",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4399936",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "541595397035",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "183922",
"state": "VA"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "3650 Steve Reynolds Blvd",
"address_2": "Kaiser Permanente Gwinnett Medical Center",
"city": "Duluth",
"state": "GA",
"country_code": "US",
"postal_code": "30096",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "PAULA",
"last_name": "JUBILEE",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Duluth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.