Provider Demographics
NPI:1760672281
Name:LEVARITY-CONLEY, KRISTY Z (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:Z
Last Name:LEVARITY-CONLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:Z
Other - Last Name:LEVARITY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3495 PIEDMONT ROAD, NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:404-504-5678
Mailing Address - Fax:404-296-8100
Practice Address - Street 1:1175 CASCADE PARKWAY
Practice Address - Street 2:KAISER PERMENTE CASCADE MEDICAL CENTER
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30311
Practice Address - Country:US
Practice Address - Phone:404-505-4006
Practice Address - Fax:404-294-6030
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA63709207Q00000X
GA063709207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA309447513EMedicaid
GA202I84866Medicare PIN