Kelly Lynn Anderson, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

060802416 Issued in GA

Practice address

3855 Pleasant Hill Rd
Suite 130
Duluth, GA 30096-1407

Phone

(678) 312-7880

Fax

(678) 312-7890

NPI assigned

Mar 6, 2017

Last updated

Mar 6, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1831639293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3855 PLEASANT HILL RD",
            "address_2": "SUITE 130",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961407",
            "telephone_number": "678-312-7880",
            "fax_number": "678-312-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3855 PLEASANT HILL RD",
            "address_2": "SUITE 130",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300961407",
            "telephone_number": "678-312-7880",
            "fax_number": "678-312-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-06",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "060802416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anchor Plus RX, LLC (Anchor Plus Pharmacy)
• Anderson and Anderson DMD PC
• Amy Caroline Anderson
• Eric David Anderson, DMD
• Eric Michael Anderson, DMD
• Olivia Faye Anderson
• Susan K Anderson, DMD
• Lucy Yelka Andia-Naylor
• Joseph Andrews, PHARMD
• Andronica Inc

• Athletic Trainer in Duluth, GA
• Providers in Duluth, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.