King's Hometown Walk-in Clinic LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

KING'S HOMETOWN WALK-IN CLINIC LLC

Practice address

214 Young Harris St Ste B
Blairsville, GA 30512-8534

Phone

(706) 400-9770

NPI assigned

Feb 27, 2023

Last updated

Feb 27, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stacy Beard-Adams

Title

Credentialing Specialist

Phone

(321) 206-1162

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Steven Michael Rouse, PA-C

  • Medical Physician Assistant
  • Blairsville, GA
  • NPI 1730132937
  Medicare reassignment

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677456000000",
    "number": "1871292078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 YOUNG HARRIS ST STE B",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305128534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 YOUNG HARRIS ST STE B",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305128534",
            "telephone_number": "706-400-9770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING'S HOMETOWN WALK-IN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A",
        "authorized_official_last_name": "BEARD-ADAMS",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "321-206-1162"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Kelley, RPH
• Joshua R Kennedy, D.O.
• Myron Edward Ketter, LCSW
• Amy Kight, MS, OTR/L
• Sarah Michelle King, L.AC
• Kings Quick Care
• Mariana Leona Kinney, OTR/L
• Jessica Lynn Kitchens, PA-C
• Janet G Kowalski, LPC
• Brian C. Kraft, CRNA

• Family Medicine Physician in Blairsville, GA
• Providers in Blairsville, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.