MEDICARE: DR. KERRIE ANN LIND MD

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	207P00000X	Emergency Medicine Physician	0101257908	VA
2	207P00000X	Emergency Medicine Physician	D0079851	MD
3	207P00000X	Emergency Medicine Physician	89945	GA
4	314000000X	Skilled Nursing Facility	89945	GA
5	2083B0002X	Obesity Medicine (Preventive Medicine) Physician	89945	GA

General Provider Information

NPI Number	:	1558774950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KERRIE ANN LIND MD

Provider Business Mailing Address
First Line	:	201 STERLING WOODS DR
Second Line	:
City	:	RICHMOND HILL
State	:	GA
Zip	:	31324-4376
Country	:	US
Telephone Number	:	770-378-5011
Fax Number	:

Provider Business Practice Location Address
First Line	:	1800 PHOENIX BLVD STE 128-12
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30349-5593
Country	:	US
Telephone Number	:	844-359-8363
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2014
Last Update Date	:	08/06/2025

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