Healthcare Provider Details

I. General information

NPI: 1013141019
Provider Name (Legal Business Name): KATHRYN SHIPP RHYNE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2009
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3950 AUSTELL RD
AUSTELL GA
30106-1121
US

IV. Provider business mailing address

800 KENNESAW AVE NW STE 200
MARIETTA GA
30060-7940
US

V. Phone/Fax

Practice location:
  • Phone: 470-732-4415
  • Fax:
Mailing address:
  • Phone: 770-427-4032
  • Fax: 770-427-4032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number156803
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: