Individual provider Active NPI

Kelli Lynn Noble, MSN, NP-C

  • Family Nurse Practitioner
  • Dalton, GA
National Provider Identifier
1942556063
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN292239 Issued in GA
Practice address
302 Point North PL
Dalton, GA 30720-2644
Phone
(706) 272-4127
Fax
(706) 279-3969
NPI assigned
Jul 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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 16842 TN
Family Nurse Practitioner 363LF0000X RN292239 GA Primary

Addresses

Primary practice location

302 Point North PL
Dalton, GA 30720-2644

Mailing address

302 Point North PL
Dalton, GA 30720-2644
Phone (706) 272-4127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20121009000222 TN Practitioner - Nurse Practitioner 8426205188
I20200603000189 GA Practitioner - Nurse Practitioner 8426205188

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bradley Polk Walk in Clinic Family Current Accepting new patients
Cleveland Back & Neck Clinic, PLLC Past Accepting new patients
Hamilton Medical Center, Inc. Past Accepting new patients

Locations

119 White Water Dr
Ocoee, TN 37361
Phone (423) 299-9435

Interoperability endpoints

  • Direct secure messaging: kelli.noble@164749367312388.direct.elationemr.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1942556063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 POINT NORTH PL",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202644",
            "telephone_number": "706-272-4127",
            "fax_number": "706-279-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 POINT NORTH PL",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202644",
            "telephone_number": "706-272-4127",
            "fax_number": "706-279-3969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "KELLI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "MSN, NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-26",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "16842",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN292239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.