Kiesha Hazelray , CNA
Physician β’ Decatur, GA
2624 Kelly Lake Rd
Decatur, GA 300326417
Phone: 4234329401
Location details and other listingsThis profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
This NPI Is Deactivated in NPPES
NPPES lists this NPI as deactivated as of September 27, 2022; the reason is not published. The records below are historical. They do not show whether Kiesha Hazelray currently practices or holds a license; check the state medical board for current license status.
Practice Location & Contact Primary Location
2624 Kelly Lake Rd
Decatur, GA 300326417
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
What Public CMS Data Show
Physician: NPPES taxonomy is a reported classification, not proof of board certification.
NPI first issued
2018
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Compared with the same specialty in Decatur and Georgia
Comparisons are not shown because NPPES lists this NPI as deactivated.
Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo Β· Report an error.
Specialties & License Numbers Reported to NPPES
NUCC Taxonomy Code: 251E00000X
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
NPPES lists this NPI as deactivated as of September 27, 2022; the reason is not published.
Registered at 209 CROLL CT APT 125, CHATTANOOGA, TN 374101017 (Tel: 4234329401)
In Home Supportive Care
NPI status registered as active in NPPES database
Registered at 2624 KELLY LAKE RD, DECATUR, GA 300326417 (Tel: 4234329401)
Registered at PO BOX 80232, CHATTANOOGA, TN 374147232 (Tel: 4234329401)
Recorded as KIESHA HAZELRAY, CNA
Home Health
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Mailing Address
Po Box 80232
Chattanooga, TN 374147232
Phone: 4234329401