NPI age
19 years
Enumerated 2006-08-20
● Active
Type 1 · Individual
Scott Asbury Kellermeyer
Kellermeyer is 1 of 51 radiology providers in Gainesville and 1 of 1280 in Georgia.
Primary specialty
Radiology
Plus 1 subspecialty
Licensed in
GA, VA
2 states
Status
Active
No deactivations on record
Last NPPES update
2019-03-06
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 1280 active radiology providers in Georgia.
NPI age
19 years
≈ at median (19 yr)
State licenses
2 states
Top 78% — 21% of peers are multi-state
Subspecialties
0
38% of peers hold subspecialties
NPI lifetime · 2006 → 2026
2006-08Enumerated in NPPES
2006
2026
Where they practice
Practice location
725 Jesse Jewell Pkwy Se
Gainesville, GA 30501
Mailing address
Po Box 658
Gainesville, GA 305030658
Additional practice locations
3 secondary locations on file with NPPES.
Location 2
725 Jesse Jewell Pkwy Se
Gainesville, GA 30501
Location 3
655 Jesse Jewell Pkwy Se Ste B
Gainesville, GA 305013854
Location 4
1270 Friendship Rd
Braselton, GA 305175630
Specialties
-
Radiology PrimaryA radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (VA) | LICENSE | 0101223420 |
| 05 (VA) | 007223676 | |
| 05 (GA) | 123832240G |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 151 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.