KILSY CUELLO PICHARDO (NPI# 1720407588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720407588 |
| Entity Type | Individual |
| Full Name | KILSY CUELLO PICHARDO |
| Credential | MD |
| Practice Address |
157 Clinic Ave Ste 203 Carrollton GA 30117-4454 |
| Mailing Address |
157 Clinic Ave Ste 203 Carrollton GA 30117-4454 |
| Practice Telephone | 7708320429 |
| Practice Fax Number | 7708389108 |
| Mailing Telephone | 7708320429 |
| Mailing Fax Number | 7708389108 |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2019-06-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 77453 | GA | Allopathic & Osteopathic Physicians |
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
77453 | GA | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 030553-R | PR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003164765B | 05 |
| Street Address |
157 CLINIC AVE STE 203 |
| City | CARROLLTON |
| State | GA |
| Zip Code | 30117-4454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306187570 | Myriam C Vela-ortiz | Internal Medicine | 157 Clinic Ave Ste 203, Carrollton, GA 30117 | 2013-03-12 |
| 1588079248 | Emily Tarpley Massey | Nurse Practitioner | 157 Clinic Ave Ste 203, Carrollton, GA 30117-4454 | 2014-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1093361404 | Eyedeal Eyecare LLC | Optometrist | 1735 S Us 27, Carrollton, GA 30117 | 2019-08-12 |
| 1710412473 | Janis James | Optometrist | 1735 S, Us-27, Walmart Vision Center, Carrollton, GA 30117 | 2017-05-01 |
| 1568881951 | Omar Hajmurad | Anesthesiology | 812 S Park St Ste 5, Carrollton, GA 30117 | 2014-04-14 |
| 1134550353 | Goodbodys Minor Med Express Care | Nurse Practitioner | 1670 South Park St., Carrollton, GA 30117 | 2013-12-13 |
| 1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
| 1952682486 | Angelic Wings Transport, Inc. | Non-emergency Medical Transport (VAN) | 362 B Columbia Drive, Carrollton, GA 30117 | 2011-08-29 |
| 1073819256 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 812 South Park Street, Suite 2, Carrollton, GA 30117 | 2011-02-04 |
| 1255640348 | Amy Gilbert | Counselor | 515 Tanner St, Carrollton, GA 30117 | 2010-10-06 |
| 1316253743 | Nichole Ann Adamson | Occupational Therapist | 180 Martin St, Carrollton, GA 30117 | 2010-08-23 |
| Find all providers in zip 30117 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932591948 | Georgia Renal and Hypertension Care Inc | Internal Medicine | 928 S Park St, Suite H, Carrollton, GA 30117-4501 | 2015-02-27 |
| 1275932204 | Ricardo Rodriguez Santos | Internal Medicine | 4333 N Josey Ln Ste 202, Carrollton, TX 75010 | 2014-08-14 |
| 1477583763 | Jun Chen | Internal Medicine | 4240 International Pkwy, Ste. 154, Carrollton, TX 75007 | 2006-07-03 |
| 1154777068 | North Texas Kidney Disease Associates | Internal Medicine | 4333 N Josey Ln, Suite 202, Carrollton, TX 75010 | 2016-05-10 |
| 1285814988 | Carroll County Nephrology LLC | Internal Medicine | 157 Clinic Ave, Suite 203, Carrollton, GA 30117-4454 | 2007-11-09 |
| 1750590691 | Deeba Nohi Ali | Internal Medicine | 4240 International Pkwy, Suite 154, Carrollton, TX 75007-1970 | 2007-05-21 |
| 1689887911 | Bryan Quinn | Internal Medicine | 157 Clinic Ave, Suit 203, Carrollton, GA 30117-4454 | 2007-05-07 |
| 1790809036 | North Texas Kidney Disease Associates | Internal Medicine | 4240 International Pkwy, Ste. 154, Carrollton, TX 75007 | 2007-03-19 |
| 1720122096 | Anjana S. Jagalur | Internal Medicine | 4333 N Josey Ln, Ste 202, Carrollton, TX 75010 | 2007-02-19 |
| 1457303323 | Matthew T Smith | Internal Medicine | 4333 N Josey Ln, Suite 202, Carrollton, TX 75010-4629 | 2006-05-17 |
| Find all providers in CARROLLTON | ||||
| City | CARROLLTON |
| Zip Code | 30117 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.