Individual provider Active NPI

Tamika L Chester, NP

  • Nurse Practitioner
  • Warner Robins, GA
National Provider Identifier
1053770669
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN200072 Issued in GA
Practice address
212 Hospital Dr Ste H
Warner Robins, GA 31088-4289
Phone
(478) 328-0281
Fax
(478) 328-0438
NPI assigned
Feb 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN200072 GA Primary

Addresses

Primary practice location

212 Hospital Dr Ste H
Warner Robins, GA 31088-4289

Mailing address

2400 Bellevue Rd Ste 21a
Dublin, GA 31021-2890
Phone (478) 328-0281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160601002939 GA Practitioner - Nurse Practitioner 5395035406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Dermatology and Skin Cancer Center, LLCGroup PAC ID 7113980855, 53 clinicians

Practice addresses (Care Compare)

1157 Forsyth St
Macon, GA 31201-7452
Phone (478) 745-8581

212 Hospital Dr
Suite C
Warner Robins, GA 31088-4247
Phone (478) 922-9281

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN200072GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Dermatology & Skin Cancer Center, LLC CurrentSince Apr 16, 2016 Accepting new patients
Georgia Dermatology &Skin Cancer Center, PC Past Accepting new patients
Georgia Dermatopathology Past Accepting new patients

Locations

2400 Bellevue Rd
Ste 21A
Dublin, GA 31021
Phone (478) 275-7202

1157 Forsyth St
Macon, GA 31201
Phone (478) 745-8581

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1053770669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 BELLEVUE RD STE 21A",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212890",
            "telephone_number": "478-328-0281",
            "fax_number": "478-328-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 HOSPITAL DR STE H",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310884289",
            "telephone_number": "478-328-0281",
            "fax_number": "478-328-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESTER",
        "first_name": "TAMIKA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN200072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.