Individual provider Active NPI

Kelly Miller Agnone, PA-C

  • Medical Physician Assistant
  • Atlanta, GA
National Provider Identifier
1841730561
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
8305 Issued in GA
Practice address
6135 Barfield Rd
Atlanta, GA 30328-4307
Phone
(678) 538-2152
NPI assigned
Feb 28, 2017
Last updated
May 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 8305 GA Primary

Addresses

Primary practice location

6135 Barfield Rd
Atlanta, GA 30328-4307

Mailing address

210 Carriage Way LN
Roswell, GA 30076-3647

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kellymiller@lmg.allscriptsdirect.net Direct

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
I20170821000974 GA Practitioner - Physician Assistant 5092087411 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Laureate Medical Group at Northside, LLCGroup PAC ID 2668458530, 75 clinicians

Practice addresses (Care Compare)

3400 A Old Milton Pkwy
Alpharetta, GA 30005-4438
Phone (678) 775-2284

Merit-based Incentive Payment System (MIPS)

Final score
80.89 of 100Reported as group
Quality
76.16
Promoting interoperability
88
Improvement activities
40
Cost
70.16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
8305GAMDObstetrics & Gynecology Physician

Interoperability endpoints

  • Direct secure messaging: kellymiller@lmg.allscriptsdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1841730561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 CARRIAGE WAY LN",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6135 BARFIELD RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284307",
            "telephone_number": "678-538-2152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGNONE",
        "first_name": "KELLY",
        "middle_name": "MILLER",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-28",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "8305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kellymiller@lmg.allscriptsdirect.net",
            "affiliation": "N",
            "endpointDescription": "direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct edge",
            "address_1": "6135 Barfield Rd",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303284307",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.