Kelly Elaine Cline, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

229177 Issued in GA

Practice address

1575 Chattanooga Ave Ste 1
Dalton, GA 30720-2672

Phone

(706) 876-2130

Fax

(706) 876-2168

NPI assigned

Oct 3, 2011

Last updated

Jan 24, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• White's Pediatrics

  • Pediatrics Physician
  • Dalton, GA
  • NPI 1104005594
  NPD (past)

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1871877381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1575 CHATTANOOGA AVE STE 1",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202672",
            "telephone_number": "706-876-2130",
            "fax_number": "706-876-2168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 CHATTANOOGA AVE STE 1",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202672",
            "telephone_number": "706-876-2130",
            "fax_number": "706-876-2168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINE",
        "first_name": "KELLY",
        "middle_name": "ELAINE",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-03",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "GA",
            "license": "229177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003140098A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane S. Clark
• Jasmine Clark
• Jennifer Kathleen Clark, LCSW
• Krista Renae Clark, M.S. CCC-SLP
• Toby Johnson Clarkson, DMD
• Callie Cobb, CRNA
• Holly Michelle Cochran, FNP-C
• Susan Cockburn, CNM
• Jeffrey L Cohen, DO
• Hugh M. Coke III, MD

• Pediatric Nurse Practitioner in Dalton, GA
• Providers in Dalton, GA by specialty
• Pediatric Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; 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.