Provider Demographics
NPI:1255521803
Name:JAMES, KIMONE MONET (MD)
Entity type:Individual
Prefix:
First Name:KIMONE
Middle Name:MONET
Last Name:JAMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 WHITCHER ST NE
Mailing Address - Street 2:SUITE 460
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1155
Mailing Address - Country:US
Mailing Address - Phone:770-427-7389
Mailing Address - Fax:770-427-1492
Practice Address - Street 1:55 WHITCHER ST NE
Practice Address - Street 2:SUITE 460
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1155
Practice Address - Country:US
Practice Address - Phone:770-427-7389
Practice Address - Fax:770-427-1492
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-02114207R00000X
LAMD.201527208M00000X
GA67477207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003122514JMedicaid
GA003122514KMedicaid
GA003122514OMedicaid
GA003122514AMedicaid
GA003122514QMedicaid
GA003122514SMedicaid
MS07220802Medicaid
GA003122514CMedicaid
GA003122514FMedicaid
GA003122514RMedicaid
GA003122514HMedicaid
GA003122514IMedicaid
GA003122514UMedicaid
GA003122514GMedicaid
GA003122514NMedicaid
GA003122514PMedicaid
GA003122514DMedicaid
GA003122514EMedicaid
GA003122514LMedicaid
GA003122514MMedicaid
GA003122514TMedicaid
LA1077445Medicaid
GA003122514IMedicaid
GA003122514PMedicaid
GA003122514UMedicaid