Katrina R Bader, CNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN050415 Issued in GA

Practice address

200 Cres Ctr Pkwy
Department of Research
Tucker, GA 30084-7047

Phone

(770) 496-3770

NPI assigned

Sep 1, 2006

Last updated

Jul 12, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Paula Katrina Rivers Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1023110053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT ROAD NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051736",
            "telephone_number": "404-364-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CRES CTR PKWY",
            "address_2": "DEPARTMENT OF RESEARCH",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300847047",
            "telephone_number": "770-496-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADER",
        "first_name": "KATRINA",
        "middle_name": "R",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN050415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULA",
            "last_name": "RIVERS",
            "middle_name": "KATRINA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Az Health Care Services LLC
• Azalea Home Care Inc
• Yenmoakebe Aziz
• B. Thompson O.D. and Associates, P.C.
• B. Thompson O.D. and Associates, PC
• Brielle Bahlman, NP
• Contresia Ladonna Bailey, M.D.
• Michael Bailey
• Cynthia Michelle Baird, OTR/L
• Krishan Bajnath

• Nurse Practitioner in Tucker, GA
• Providers in Tucker, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.