MRS. BEVERLY D. ROSEBERRY (NPI# 1801942552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801942552 |
| Entity Type | Individual |
| Full Name | MRS. BEVERLY D. ROSEBERRY |
| Credential | APRN |
| Practice Address |
1733 Lake Rockaway Rd Nw Conyers GA 30012-3152 |
| Mailing Address |
Po Box 4715 Atlanta Atlanta GA 30302-4715 |
| Practice Telephone | 4047484123 |
| Practice Fax Number | 8663409148 |
| Mailing Telephone | 4047484123 |
| Mailing Fax Number | 8663409148 |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2009-07-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
RN065472 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PEACHSTATE HEALTH PLANS | 000735314C | 01 | |
| GA | 000735314C | 05 | |
| GA | AMERIGROUP | 10039885 | 01 |
| GA | WELLCARE | 319492 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780857698 | Beverly J Roseberry | Family Medicine | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2008-04-11 |
| Street Address |
1733 LAKE ROCKAWAY RD NW |
| City | CONYERS |
| State | GA |
| Zip Code | 30012-3152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962774083 | Helping Hands Computer Outreach | Clinic/Center | 1733 Lake Rockaway Rd Nw, Conyers, GA 30012-3152 | 2012-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578188306 | The Eye Md | Ophthalmology | 1359 Milstead Road, Suite #103, Conyers, GA 30012 | 2020-06-08 |
| 1043855836 | Maurvet Minto | Counselor | 1175 Green St, Conyers, Conyers, GA 30012 | 2019-11-15 |
| 1770054561 | Sarah Elizabeth Brooks | Physical Medicine & Rehabilitation | 1290 Milstead Ave Ne, Conyers, GA 30012 | 2018-12-06 |
| 1679091276 | Valorie Antoinette Jones | Counselor | 1175 Green St Se, Conyers, GA 30012 | 2017-09-02 |
| 1558886341 | Synergy Radiology, LLC | Radiology | 1501 Milstead Road, Suite 140, Conyers, GA 30012 | 2017-08-14 |
| 1558813295 | Salon Lyon, LLC | Specialist | 1112 West Ave, Se, B, Conyers, GA 30012 | 2016-10-28 |
| 1992252753 | Traci Hunter Bryan | Pharmacist | 1501 Milstead Ave Ne, Suite 110, Conyers, GA 30012 | 2016-09-08 |
| 1316491830 | Hye Rim Kim | Anesthesiologist Assistant | 1380 Milstead Rd Ne, Suite G, Conyers, GA 30012 | 2016-08-12 |
| 1235591397 | David Jeffrey Wasserman | Optometrist | 1192 Dogwood Dr Sw, Conyers, GA 30012 | 2016-03-28 |
| 1174919187 | Anique Archer | Health Educator | 2170 Lester Rd Nw, Conyers, GA 30012 | 2015-04-07 |
| Find all providers in zip 30012 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730188004 | Lan Thi Vu | Nurse Practitioner | 2750 Owens Drive, Suite A, Conyers, GA 30094 | 2005-07-19 |
| 1255643847 | Kenya M Prade | Nurse Practitioner | 1415 Milstead Rd Ne, Suite A, Conyers, GA 30012 | 2010-07-12 |
| 1801843222 | Marcia Watson | Nurse Practitioner | 1567 Milstead Rd Ne, Suite B, Conyers, GA 30012-3835 | 2006-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497368328 | Jennifer Cobb | Nurse Practitioner | 130 Champlain St, Decatur, GA 30030-1803 | 2020-08-29 |
| 1336766476 | Nadine L Donahue | Nurse Practitioner | 1703 Oglethorpe Dr Ne, Brookhaven, GA 30319-2791 | 2020-07-05 |
| 1003465337 | Kaitlin Wilson | Nurse Practitioner | 5195 Jimmy Carter Blvd, Norcross, GA 30093-1649 | 2019-09-09 |
| 1912555939 | Erika Parks | Nurse Practitioner | 81 Upper Riverdale Rd Sw Ste 210, Riverdale, GA 30274-2627 | 2019-09-03 |
| 1427600469 | Kytrena L Harris | Nurse Practitioner | 232 Seaton Ave, Grovetown, GA 30813-4259 | 2019-07-10 |
| 1720640162 | Sonya Coutee Wallace | Nurse Practitioner | 3200 Highlands Pkwy Se Ste 420, Smyrna, GA 30082-5192 | 2019-07-06 |
| 1134783152 | Julia Coleman Quinn | Nurse Practitioner | 220 Cobb Pkwy N Ste 500, Marietta, GA 30062-3580 | 2019-04-24 |
| 1144782749 | Keely Darnell | Nurse Practitioner | 133 Samaritan Dr Ste 306, Cumming, GA 30040-2396 | 2019-04-02 |
| 1578020103 | Stacey Leigh Newpher | Nurse Practitioner | 960 Johnson Fy Rd Ne Ste 130, Atlanta, GA 30342-1601 | 2019-03-01 |
| 1144702226 | Veneah Shante Hall | Nurse Practitioner | 440 Moreland Ave Se, Atlanta, GA 30316-1926 | 2018-09-05 |
| 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.