Individual provider Active NPI

Katy Poole

  • Family Nurse Practitioner
  • Dalton, GA
National Provider Identifier
1861932113
Registry record updated Mar 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
223046 Issued in GA
Practice address
1436 Chattanooga Ave
Dalton, GA 30720-2637
Phone
(706) 226-2142
NPI assigned
Mar 6, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 223046 GA Primary
Family Nurse Practitioner 363LF0000X 22296 TN

Addresses

Primary practice location

1436 Chattanooga Ave
Dalton, GA 30720-2637

Mailing address

550 Acorn CT
Chattanooga, TN 37415-4815
Phone (404) 372-4065

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
I20170922001772 GA Practitioner - Nurse Practitioner 2163796509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1436 Chattanooga Ave
Dalton, GA 30720-2637
Phone (706) 226-2142

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
223046GAMDFamily Nurse Practitioner
22296TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dalton Ear Nose & Throat Associates CurrentSince Jun 17, 2017 Accepting new patients
Dalton Ear Nose & Throat Associates CurrentSince Jun 17, 2017 Accepting new patients

Locations

705 Red Bud Rd NE
Calhoun, GA 30701
Phone (706) 629-1852

1436 Chattanooga Ave
Dalton, GA 30720
Phone (706) 226-2142

Interoperability endpoints

  • Direct secure messaging: katy.poole.1@7297.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/7297/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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 4

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": "1488758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1861932113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 ACORN CT",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374154815",
            "telephone_number": "404-372-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1436 CHATTANOOGA AVE",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202637",
            "telephone_number": "706-226-2142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POOLE",
        "first_name": "KATY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-06",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "223046",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22296",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.