Individual provider Active NPI

Dana E Dewberry, RNFA

  • Registered Nurse First Assistant
  • Carrollton, GA
National Provider Identifier
1104053453
Registry record updated Jun 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
RN106286 Issued in GA
Practice address
211 Laurel LN
Carrollton, GA 30116-6499
Phone
(770) 639-4189
NPI assigned
Jun 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X RN106286 GA Primary

Addresses

Primary practice location

211 Laurel LN
Carrollton, GA 30116-6499

Mailing address

211 Laurel LN
Carrollton, GA 30116-6499
Phone (770) 639-4189

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN106286GAMDRegistered Nurse First Assistant

NPI Registry JSON

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

{
    "created_epoch": "1244937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244937600000",
    "number": "1104053453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 LAUREL LN",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301166499",
            "telephone_number": "770-639-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 LAUREL LN",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301166499",
            "telephone_number": "770-639-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWBERRY",
        "first_name": "DANA",
        "middle_name": "E",
        "credential": "RNFA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-14",
        "last_updated": "2009-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "GA",
            "license": "RN106286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2009; 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.