Individual provider Active NPI

Rachel Stuckey Easterwood, WHNP-BC

  • Women's Health Nurse Practitioner
  • Dalton, GA
National Provider Identifier
1053913160
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
RN248691 Issued in GA
Practice address
303 W Waugh St
Dalton, GA 30720-3116
Phone
(706) 529-8076
Fax
(706) 529-8081
NPI assigned
Nov 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 28536 TN
Women's Health Nurse Practitioner 363LW0102X RN248691 GA Primary

Addresses

Primary practice location

303 W Waugh St
Dalton, GA 30720-3116

Mailing address

303 W Waugh St
Dalton, GA 30720-3116
Phone (706) 529-8076

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
I20210225001774 GA Practitioner - Nurse Practitioner 7214342203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magnolia Womens Health LLCGroup PAC ID 9830580687, 4 clinicians

Practice addresses (Care Compare)

303 W Waugh St
Dalton, GA 30720-3116
Phone (706) 529-8076

Hospital & facility affiliations

  • Hamilton Medical Center Hospital, Dalton, GA, CCN 110001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN248691GAMDWomen's Health Nurse Practitioner
28536TNMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Womens Health LLC Women'S Health CurrentSince Sep 21, 2021 Accepting new patients

Locations

303 W Waugh St
Dalton, GA 30720
Phone (706) 529-8076

Interoperability endpoints

  • Direct secure messaging: rachel.easterwood.1@28519.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1605139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1053913160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 W WAUGH ST",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203116",
            "telephone_number": "706-529-8076",
            "fax_number": "706-529-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W WAUGH ST",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203116",
            "telephone_number": "706-529-8076",
            "fax_number": "706-529-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTERWOOD",
        "first_name": "RACHEL",
        "middle_name": "STUCKEY",
        "credential": "WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-12",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TN",
            "license": "28536",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN248691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.