NURSE PRACTIONER (NPI# 1629519202) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629519202 |
| Entity Type | Organization |
| Organization Name | NURSE PRACTIONER |
| Practice Address |
4044 George Busbee Pkwy Nw Apt 4207 Kennesaw GA 30144-6890 |
| Mailing Address |
Po Box 1234 Powder Springs GA 30127-7234 |
| Practice Telephone | 4045791658 |
| Mailing Telephone | 4045791658 |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2017-03-15 |
| Authorized Official Name | ROSE KOMBE (FNP) |
| Authorized Official Telephone | 4045791658 |
| Authorized Official Credential | NP |
| Is Organization Subpart | Y |
| Parent Organization Name | INDEPENDENT CONTRACTOR |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 305S00000X | Point of Service | 193760 | GA | Managed Care Organizations |
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
193760 | GA | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | NURSE PRACTIONER GROUP OF SPOKANE | 1225, Spokane, WA 99210 |
| New York State Corporations | NURSE PRACTIONER IN PSYCHIATRY HEALTH WELLNESS PLLC | 1 Hoffman Street, Auburn, Ny 13021 |
| Street Address |
4044 GEORGE BUSBEE PKWY NW APT 4207 |
| City | KENNESAW |
| State | GA |
| Zip Code | 30144-6890 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205440054 | Physician Assistant Surgical Solutions | Surgery | 4290 Bells Ferry Road, Suite 134 - 1032, Kennesaw, GA 30144 | 2020-08-31 |
| 1487149340 | Creative Family Care Inc. | Social Worker | 1275 Shiloh Rd Nw Ste 3030, Kennesaw, GA 30144 | 2018-06-24 |
| 1033632203 | Octavio Andres Tobar | Specialist/Technologist | 1950 Barrett Lakes Blvd Nw Apt 1213, Kennesaw, GA 30144 | 2017-07-19 |
| 1851829220 | Sharon Mcmillan | Counselor | 1301 Shiloh Rd Nw Ste 1840, Kennesaw, GA 30144 | 2017-05-31 |
| 1073054680 | Metropolitan Health Care Plus Inc | Home Health | 445 Laurian Way, Kennesaw, GA 30144 | 2017-03-15 |
| 1649627969 | Caresouth Hha Holdings of Gainesville, LLC | Hospice Care, Community Based | 1000 Cobb Place Blvd Nw Ste 310, Kennesaw, GA 30144 | 2016-05-17 |
| 1851745988 | Joseph Mulligan | Social Worker | 1301 Shiloh Rd., Ste. 849, Kennesaw, GA 30144 | 2016-04-14 |
| 1629438601 | Youfit Health Clubs | Clinic/Center | 3895 Cherokee St Suite 100, Kennesaw, GA 30144 | 2016-03-03 |
| 1598156317 | Jodie Evans | Specialist | 1925 Vaughn Rd, Ste 200, Kennesaw, GA 30144 | 2015-02-16 |
| 1912302134 | Sleepmed Therapies, Inc. | Durable Medical Equipment & Medical Supplies | 1000 Cobb Place Blvd Nw Ste 510, Kennesaw, GA 30144 | 2014-10-30 |
| Find all providers in zip 30144 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629693411 | Priority Health and Wellness | Clinic/Center | 3855 Oakview Dr Ste 400, Powder Springs, GA 30127-2233 | 2020-06-08 |
| 1508494519 | Solvent LLC | Clinic/Center | 104 Brandon Way, Byron, GA 31008-5433 | 2020-03-27 |
| 1275178683 | Lezthon Homecare Inc | Clinic/Center | 2884 Snapfinger Mnr, Decatur, GA 30035-4167 | 2019-11-08 |
| 1023650231 | Tony Moses | Clinic/Center | 4650 Dawn Ct, Columbus, GA 31907-6655 | 2019-10-09 |
| 1174183172 | Your Choice Home Care LLC | Clinic/Center | 3326 Madison Ridge Trl, Snellville, GA 30039-6815 | 2019-06-20 |
| 1700357878 | The Shafiq Group | Clinic/Center | 910 Athens Hwy Ste K245, Loganville, GA 30052-4952 | 2018-12-16 |
| 1518477157 | Choosing Independence Inc | Clinic/Center | 115 Martin Luther King Jr Dr Sw Ste 225-102, Atlanta, GA 30303-3536 | 2017-10-10 |
| 1295256857 | Brittany Carter Lcsw LLC | Clinic/Center | 5000 Austell Powder Springs Rd Ste 283-1, Austell, GA 30106-2442 | 2017-07-03 |
| 1922539725 | Mpowerr Health & Wellness of Atlanta Inc. | Clinic/Center | 3616 Ginnis Rd Sw Unit 2, Atlanta, GA 30331-8574 | 2017-03-23 |
| 1093172652 | M D Whitest Medical Institute Inc | Clinic/Center | 401 N 15th St, Cordele, GA 31015-2932 | 2016-01-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.