Individual provider Active NPI

Sallie Key, FNP

  • Family Nurse Practitioner
  • Canton, GA
National Provider Identifier
1821142605
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN152212 Issued in GA
Practice address
301 Dogwood HTS Ste 200
Canton, GA 30114-7764
Phone
(770) 910-4541
Fax
(770) 910-4541
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X RN0000116942 TN
General Practice Registered Nurse 163WG0000X RN152212 GA
Family Nurse Practitioner 363LF0000X APN0000007667 TN
Family Nurse Practitioner 363LF0000X 809329 TX
Family Nurse Practitioner 363LF0000X RN152212 GA Primary

Addresses

Primary practice location

301 Dogwood HTS Ste 200
Canton, GA 30114-7764

Mailing address

301 Dogwood HTS
Canton, GA 30114-7764
Phone (770) 910-4541

Other identifiers 5

IdentifierTypeStateIssuer
311920802MedicaidTX
P01446964OtherTXRR
3908789MedicaidTN
8EH586OtherTXBCBS
311920801MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2435TNMDChiropractor
RN0000116942TNMDGeneral Practice Registered Nurse
7667TNMDPhysical Therapist
APN0000007667TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sallie Early Healthcare Services CurrentSince Jul 29, 2001 Accepting new patients
Cleveland Medical Clinic Inc Past Accepting new patients
Cherokee Health Systems Past Accepting new patients

Locations

1012 Jamestown Way
Maryville, TN 37803
Phone (865) 984-7400

Organizations & group practices 3

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1821142605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 DOGWOOD HTS",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301147764",
            "telephone_number": "770-910-4541",
            "fax_number": "770-910-4541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 DOGWOOD HTS STE 200",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301147764",
            "telephone_number": "770-910-4541",
            "fax_number": "770-910-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEY",
        "first_name": "SALLIE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "TN",
            "license": "RN0000116942",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "GA",
            "license": "RN152212",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000007667",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "809329",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN152212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "311920802",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR",
            "identifier": "P01446964",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3908789",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8EH586",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "311920801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.