Individual provider Active NPI

Kiana Movahed Ohlson, NP

  • Family Nurse Practitioner
  • Brookhaven, GA
National Provider Identifier
1851806244
Registry record updated Dec 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN236464 Issued in GA
Practice address
3369 Buford Hwy NE Ste 810
Brookhaven, GA 30329-3722
Phone
(404) 321-4692
NPI assigned
Dec 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN236464 GA Primary

Addresses

Primary practice location

3369 Buford Hwy NE Ste 810
Brookhaven, GA 30329-3722

Mailing address

3369 Buford Hwy NE Ste 810
Brookhaven, GA 30329-3722
Phone (404) 321-4692

Other identifiers 1

IdentifierTypeStateIssuer
RN236464OtherGARN LICENSE

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
I20181029002651 GA Practitioner - Nurse Practitioner 9032462635 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry NE
Atlanta, GA 30342-1606

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 851-8000

1100 Johnson Ferry Rd
Suite 410
Atlanta, GA 30342-1709
Phone (404) 847-0664

Hospital & facility affiliations

  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN236464GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Surgical Professional Services LLC CurrentSince Oct 3, 2022 Accepting new patients
Breast Care Specialists CurrentSince May 26, 2022 Accepting new patients
Cerium Family Practice and Urgent Medicine, LLC PastSince Dec 2, 2020 Accepting new patients

Locations

975 Johnson Ferry Rd
Ste 5
Atlanta, GA 30342
Phone (404) 255-8086

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512518400000",
    "number": "1851806244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3369 BUFORD HWY NE STE 810",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303293722",
            "telephone_number": "404-321-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3369 BUFORD HWY NE STE 810",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303293722",
            "telephone_number": "404-321-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OHLSON",
        "first_name": "KIANA",
        "middle_name": "MOVAHED",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN236464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN236464",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

Verify at the official NPI Registry.