Active NPI
Katelyn Enderle
- Physician Assistant
- Douglasville, GA
National Provider Identifier
1902726631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 6002 Professional Pkwy Ste 140
Douglasville, GA 30134-5603 - Phone
- (678) 715-9690
- NPI assigned
- Jul 21, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
6002 Professional Pkwy Ste 140
Douglasville, GA 30134-5603
Mailing address
106 Stoney Way
Carrollton, GA 30116-5108
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1784592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1784592000000",
"number": "1902726631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 STONEY WAY",
"city": "CARROLLTON",
"state": "GA",
"postal_code": "301165108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6002 PROFESSIONAL PKWY STE 140",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301345603",
"telephone_number": "678-715-9690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENDERLE",
"first_name": "KATELYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-07-21",
"last_updated": "2026-07-21",
"certification_date": "2026-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.