Individual provider Active NPI

Kiery Ann Braithwaite, MD

  • Pediatric Radiology Physician
  • Atlanta, GA
National Provider Identifier
1811031073
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
54554 Issued in GA
Practice address
1405 Clifton Rd NE
Atlanta, GA 30322-1060
Phone
(404) 785-6541
Fax
(404) 785-1248
NPI assigned
Feb 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X 54554 GA Primary

Addresses

Primary practice location

1405 Clifton Rd NE
Atlanta, GA 30322-1060

Mailing address

1405 Clifton Rd NE
Atlanta, GA 30322-1060
Phone (404) 785-6541

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071024000442 GA Practitioner - Diagnostic Radiology 0042307951 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Georgetown University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choa Hospital Based, LLCGroup PAC ID 4688812498, 97 clinicians

Practice addresses (Care Compare)

1405 Clifton Rd NE
Atlanta, GA 30022-1060
Phone (404) 785-2000

2220 N Druid Hills Rd NE
Atlanta, GA 30329-3117
Phone (404) 785-5437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
54554GAMDPediatric Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Choa Multispecialty, LLC Current Accepting new patients
The Emory Clinic Inc CurrentSince Jul 1, 2007 Accepting new patients
Emory Medical Care Foundation Inc Pediatric Radiology CurrentSince Jul 1, 2007 Accepting new patients
Choa Hospital Based, LLC Pediatric Radiology CurrentSince Jul 1, 2013 Accepting new patients
Emory Medical Care Foundation Inc Current Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370

101 W Ponce de Leon Ave
Ste 300
Decatur, GA 30030
Phone (404) 778-4889

Interoperability endpoints

  • Direct secure messaging: kbraithwaite6783@choa.gadirect.net

Organizations & group practices 5

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": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1811031073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221060",
            "telephone_number": "404-785-6541",
            "fax_number": "404-785-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303221060",
            "telephone_number": "404-785-6541",
            "fax_number": "404-785-1248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAITHWAITE",
        "first_name": "KIERY",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "GA",
            "license": "54554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "1405 Clifton Rd NE",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303221060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.