Kingdom Healthcare Services, LLC
NPI 1750913349 · Primary Care Clinic/Center · Hiram, GA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Kingdom Healthcare Services, LLC is a Primary Care Clinic/Center organization in Hiram, GA (NPI 1750913349).
Provider details
- NPI number
- 1750913349
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Lucille Travis, Ceo(678) 978-4947
Specialties & taxonomies
Ambulatory Health Care Facilities
- Nursing Care Agency251J00000X
Agencies
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 215 Palisades DrDallas, GA 30157-0928Phone: (678) 978-4947
Registry dates
- Enumerated
- 2020-02-11
- Last updated
- 2023-10-22
- Certified
- 2023-10-22
Frequently asked questions
- What is Kingdom Healthcare Services, LLC's NPI number?
- Kingdom Healthcare Services, LLC's National Provider Identifier (NPI) is 1750913349, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Kingdom Healthcare Services, LLC?
- Kingdom Healthcare Services, LLC is classified in the NPPES registry as Primary Care Clinic/Center (Ambulatory Health Care Facilities).
- Where is Kingdom Healthcare Services, LLC located?
- Kingdom Healthcare Services, LLC's practice location on file with NPPES is 4095 Atlanta Hwy, Hiram, GA 30141-1854.
- What is Kingdom Healthcare Services, LLC's phone number?
- The practice phone number listed in the NPPES registry for Kingdom Healthcare Services, LLC is (404) 488-9521.
- Does Kingdom Healthcare Services, LLC accept Medicare?
- Kingdom Healthcare Services, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Kingdom Healthcare Services, LLC?
- The authorized official listed on Kingdom Healthcare Services, LLC's NPPES record is Lucille Travis, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Kingdom Healthcare Services, LLC's NPI active?
- Yes — Kingdom Healthcare Services, LLC's NPI (1750913349) is active in the NPPES registry as of the last update on 2023-10-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.