MEDICARE: KINGSLEY CLINIC OF GEORGIA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1124621487
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KINGSLEY CLINIC OF GEORGIA LLC

Provider Business Mailing Address
First Line	:	33471 BILTMORE DR
Second Line	:
City	:	TEMECULA
State	:	CA
Zip	:	92592-1849
Country	:	US
Telephone Number	:	530-305-7637
Fax Number	:

Provider Business Practice Location Address
First Line	:	11720 AMBERPARK DR STE 160
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30009-2271
Country	:	US
Telephone Number	:	770-580-1905
Fax Number	:	912-216-3703

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES KINGSLEY
Credential	:	MD
Telephone Number	:	770-580-1905

Provider Enumeration Date	:	11/19/2020
Last Update Date	:	01/31/2024

Similar Medicare Providers

1275024002 — PROJECT BELLE LLC
Practice Location Address:

11720 AMBER PARK DR STE 160
ALPHARETTA, GA
30009-2271

Practice Phone: 855-232-7888
Practice Fax: 603-912-8394

1134474620 — JOCLYN SIMS WINDOM LPC
Practice Location Address:

11720 AMBER PARK DR STE 160
ALPHARETTA, GA
30009-2271

Practice Phone: 334-552-1846
Practice Fax:

1225447253 — NAIA TILGHMAN LPC
Practice Location Address:

11720 AMBER PARK DR STE 160
ALPHARETTA, GA
30009-2271

Practice Phone: 678-696-0463
Practice Fax:

1932870557 — KYLE SMITH
Practice Location Address:

11720 AMBERPARK DR STE 160
ALPHARETTA, GA
30009-2271

Practice Phone: 770-870-1812
Practice Fax:

1396488433 — JORDAN ABERNATHY-CORNELIUS LCSW
Practice Location Address:

11720 AMBERPARK DR STE 160
ALPHARETTA, GA
30009-2271

Practice Phone: 470-695-0024
Practice Fax:

1861174732 — SOUTHERN COAST TRANSIT
Practice Location Address:

11720 AMBER PARK DR STE 160
ALPHARETTA, GA
30009-2271

Practice Phone: 470-664-2700
Practice Fax:

Directions to “KINGSLEY CLINIC OF GEORGIA LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.