Caroline C Anaele, FNP
Individual provider Active NPI Nurse Practitioner · Douglasville, GA
NPI 1104130368 · NPPES record last updated Oct 13, 2014
Key facts
- NPI
- 1104130368
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- RN135346 (GA)
- Practice address
- 2121 Fairburn Road
Suite B
Douglasville, GA 30135-1029 - Phone
- (678) 594-3881
- Fax
- (678) 594-3871
- NPI assigned
- Jul 29, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2121 Fairburn Rd
Suite B
Douglasville, GA 30135-1029
Phone (678) 594-3881
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101108000249 | GA | Practitioner - Nurse Practitioner | 4789879552 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stella Medical Center | Nurse Practitioner | Current |
Accepting new patients |
| Clark Robinson, M.D.,P.C. | Past | Accepting new patients | |
| One Stop Medical Clinic | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN135346 | GA | Yes |
Addresses
Primary practice location
2121 Fairburn Road
Suite B
Douglasville, GA 30135-1029
Mailing address
2121 Fairburn Road
Suite B
Douglasville, GA 30135-1029
Phone (678) 594-3881
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 456441108 | Medicaid | GA |
Other providers in Douglasville, GA
- Marc Greg Amaya
- Amazing Natural Health & Wellness, LLC
- Amedisys Georgia, LLC
- America'S Best Contacts & Eyeglasses
- American EMS
- Ariana Kaleigh Anderson
- Cassandra Beth Anderson
- Joi Noel Anderson
- Julia Anderson
- Juliet Anderson
All providers in Douglasville, GA · Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.