Keri Lynn Altman, NP-C
Individual provider Active NPI Nurse Practitioner · Carrollton, GA
NPI 1962851352 · NPPES record last updated Mar 25, 2025
Key facts
- NPI
- 1962851352
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- RN213457 (GA)
- Practice address
- 107 Wedgewood Dr
Carrollton, GA 30117-4335 - Phone
- (678) 390-7070
- Fax
- (678) 390-7071
- NPI assigned
- Jun 7, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170103001336 | GA | Practitioner - Nurse Practitioner | 3072894138 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tift Regional Health System Inc | Current |
Accepting new patients | |
| 3:16 Urgent Care LLC | Current |
Accepting new patients | |
| Tift Regional Health System Inc | Current |
Accepting new patients |
Locations
1009 Alabama Ave S
Bremen, GA 30110
Phone (678) 821-1660
820 Maple St
Carrollton, GA 30117
Phone (678) 390-7900
2225 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-3422
2227 US Highway 41 N
Tifton, GA 31794
Phone (229) 353-6188
Interoperability endpoints
- keri.altman.1@22071.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN213457 | GA | |
| Nurse Practitioner | 363L00000X | RN213457 | GA | Yes |
Addresses
Primary practice location
107 Wedgewood Dr
Carrollton, GA 30117-4335
Mailing address
PO Box 728
Bremen, GA 30110-0728
Phone (770) 537-1234
Other practice location 1
1009 Alabama Ave S
Bremen, GA 30110-2501
Phone (678) 821-6400
Other practice location 2
820 Maple St
Carrollton, GA 30117-3626
Phone (678) 390-7915
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861915647 | Other | GA | GROUP NPI |
Other providers in Carrollton, GA
- Tenecia Latonya Allen
- William Keith Allison
- Dawn M Allred
- Lindsay Nichole Allred
- Lorien T Altadonna
- Ama Therapy & Co., Inc.
- Cynthia Ann Amante
- Amd Healthcare, LLC
- Amedisys Georgia, L.L.C.
- Amy Wagner, LLC
All providers in Carrollton, GA · Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.