KELDRECA S THOMAS


Address: 868 York Ave Sw, Atlanta, GA 30310
Phone: 4047521400

KELDRECA S THOMAS (NPI# 1447797600) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1447797600
Entity Type Individual
Full Name KELDRECA S THOMAS
Credential FNP
Practice Address 868 York Ave Sw
Atlanta
GA 30310
Mailing Address 868 York Ave Sw
Atlanta
GA 30310-2750
Practice Telephone 4047521400
Enumeration Date 2017-01-26
Last Update Date 2019-11-12
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363LF0000X Nurse Practitioner
Specialization: Family
RN230389 GA Physician Assistants & Advanced Practice Nursing Providers
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
RN230389 GA Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
2429 Martin Luther King Jr Dr Sw, Atlanta, GA 30311 8663892727

Office Location

Street Address 868 YORK AVE SW
City ATLANTA
State GA
Zip Code 30310

Providers in the same location

NPI Name Taxonomy Address Enumeration
1720080989 The Family Health Centers of Georgia, Inc Clinic/Center 868 York Ave Sw, Atlanta, GA 30310-2750 2005-06-01
1255940151 Compass Health Systems of Georgia Counselor 868 York Ave Sw, Atlanta, GA 30310-2750 2020-07-27
1700403599 Rebecca Nicole Adams Nurse Practitioner 868 York Ave Sw, Atlanta, GA 30310-2750 2020-06-29
1750846069 Canelda Tashay Perry Nurse Practitioner 868 York Ave Sw, Atlanta, GA 30310-2750 2019-01-31
1295234938 Lashanda Gabrielle Putman Nurse Practitioner 868 York Ave Sw, Atlanta, GA 30310-2750 2018-02-08
1366968851 Amri R Khalfani Dental Hygienist 868 York Ave Sw, Atlanta, GA 30310-2750 2017-08-16
1801346721 Monica Poole Social Worker 868 York Ave Sw, Atlanta, GA 30310-2750 2016-10-04
1639626591 Labraile Mccoy Nurse Practitioner 868 York Ave Sw, Atlanta, GA 30310-2750 2016-09-07
1306399977 The Family Health Centers of Georgia Clinic/Center 868 York Ave Sw, Atlanta, GA 30310-2750 2016-07-29
1376993600 Emilea Emade Mfortow Nurse Practitioner 868 York Ave Sw, Atlanta, GA 30310 2016-06-17
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1134775208 Naesm Mens Health and Wellness Center Clinic/Center 2140 Martin Luther King Jr Dr Sw Ste 201, Atlanta, GA 30310 2019-08-14
1588219810 Dayana Regis Pediatrics 808 York Ave Sw, Atlanta, GA 30310 2019-08-04
1629636683 Manan Shah Student in an Organized Health Care Education/Training Program 720 Westview Dr, Sw Morehouse School of Medicine/gme, Atlanta, GA 30310 2019-06-04
1780242420 Fortunate Amarachukwu Ejimone Student in an Organized Health Care Education/Training Program 720 Westview Dr. Sw Morehouse School of Medicine/gme, Atlanta, GA 30310 2019-05-29
1922589589 Bria Campbell Counselor 1009 Windsor St Sw, Atlanta, GA 30310 2018-08-22
1821583584 Onyedikachi Kenneth Michaels Student in an Organized Health Care Education/Training Program Morehouse School of Medicine / Gme, 720 Westview Dr, Sw, Atlanta, GA 30310 2018-06-26
1881185387 Precious Oghenefejiro Odunvbun Student in an Organized Health Care Education/Training Program 720 West View Dr Sw Morehouse School of Medicine/gme, Department of Medicine, Atlanta, GA 30310 2018-05-21
1598253908 Chinonyelum Doris Nwagbara Student in an Organized Health Care Education/Training Program Morehouse School of Medicine, Gme 720 Westview Drive Sw, Atlanta, GA 30310 2018-05-01
1679060552 Danielle Nicole Oliver Student in an Organized Health Care Education/Training Program Morehouse School of Medicine/gme 720 Westview Dr Sw, Atlanta, GA 30310 2018-04-17
1376049072 Ngozi Egondu Okanu Student in an Organized Health Care Education/Training Program Gme 720 Westview Dr, Sw, Atlanta, GA 30310 2018-04-02
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1659989549 Bosede Omolara Babalola-adejokun Nurse Practitioner 160 Magnolia Walk Ln, Atlanta, GA 30349-4067 2020-07-16
1891313276 Health Medix Center Inc Nurse Practitioner 5401 Boreal Way Sw, Atlanta, GA 30331-9215 2020-07-11
1831736826 Carol Lorraine Borchers Nurse Practitioner 3648 Peachtree Rd Ne Apt 1j, Atlanta, GA 30319-1271 2019-12-09
1033606165 Jane Wanjiru Waweru Nurse Practitioner 635 Windy Ridge Ln Se, Atlanta, GA 30339-2438 2018-04-14
1780198820 Joanne Patrice Parks Nurse Practitioner 3110 Henderson Walk, Atlanta, GA 30340-4329 2017-11-28
1013467570 Jill Morich Webb Nurse Practitioner 2150 Peachford Rd Ste Q, Atlanta, GA 30338-6539 2016-10-09
1518413897 Terre Cheely Nurse Practitioner 2 Ravinia Drive Suite 500, Atlanta, GA 30346 2016-08-28
1407211964 Donna D. Wilson Nurse Practitioner 35 Collier Rd Nw Ste 425, Atlanta, GA 30309-1613 2015-12-28
1265785596 Shikira Mone' Woods Nurse Practitioner 101 Marietta St Nw Ste 350, Atlanta, GA 30303-2724 2012-10-24
1104846385 Elizabeth L Robinson Nurse Practitioner 289 Little St Se, Atlanta, GA 30315-1364 2006-07-20
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Competitor

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City ATLANTA
Zip Code 30310

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Dataset Information

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.

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