Individual provider Active NPI

Yolonda Michelle Rawls

  • Nurse Practitioner
  • Dallas, GA
National Provider Identifier
1053986174
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1045202 Issued in TX
Practice address
149 Parkmont Court
Dallas, GA 30132
Phone
(770) 866-1777
NPI assigned
May 21, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN205166 GA
Nurse Practitioner 363L00000X 1045202 TX Primary

Addresses

Primary practice location

149 Parkmont Court
Dallas, GA 30132

Mailing address

2774 Cobb Pkwy NW Ste 109
Kennesaw, GA 30152-3497
Phone (770) 866-1777

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL yrawlsrn@gmail.com Health Information Exchange (HIE)

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
I20240625001529 GA Practitioner - Nurse Practitioner 8628461944 Reassigns benefits to 2 organizations

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
Cobbwest Internal Medicine AssociatesGroup PAC ID 1951544139, 3 clinicians

Practice addresses (Care Compare)

848 Hiram Acworth Hwy
Suite a
Hiram, GA 30141-2399
Phone (678) 324-7021

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN205166GAMDNurse Practitioner
1045202TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cobbwest Internal Medicine Associates CurrentSince May 29, 2024 Accepting new patients

Locations

848 Hiram Acworth Hwy
Ste 200
Hiram, GA 30141
Phone (678) 324-7021

848 Hiram Acworth Hwy
Hiram, GA 30141
Phone (404) 769-3084

848 Hiram Acworth Hwy
Ste 100
Hiram, GA 30141
Phone (404) 334-7575

Organizations & group practices 2

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": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1053986174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2774 COBB PKWY NW STE 109",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523497",
            "telephone_number": "770-866-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 PARKMONT COURT",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "30132",
            "telephone_number": "770-866-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAWLS",
        "first_name": "YOLONDA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-21",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN205166",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "1045202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "yrawlsrn@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2774 Cobb Pkwy NW Ste 109",
            "city": "Kennesaw",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301523497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

Verify at the official NPI Registry.