Individual provider Active NPI

Rowena W Elliott, PH.D.

  • Adult Health Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1104378678
Registry record updated Feb 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN259680 Issued in GA
Practice address
7 Executive Park Dr NE
Apt. 1301
Atlanta, GA 30329-2250
Phone
(601) 597-2787
NPI assigned
Oct 31, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Registered Nurse 163WG0600X RN259680 GA
Gerontology Registered Nurse 163WG0600X R624608 MS
Adult Health Nurse Practitioner 363LA2200X 901572 MS
Adult Health Nurse Practitioner 363LA2200X RN259680 GA Primary

Addresses

Primary practice location

7 Executive Park Dr NE
Apt. 1301
Atlanta, GA 30329-2250

Mailing address

1520 Clifton Rd NE
Atlanta, GA 30322-4201
Phone (404) 727-8170

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
R624608MSMDGerontology Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517443200000",
    "number": "1104378678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303224201",
            "telephone_number": "404-727-8170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 EXECUTIVE PARK DR NE",
            "address_2": "APT. 1301",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292250",
            "telephone_number": "601-597-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "ROWENA",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-31",
        "last_updated": "2018-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "GA",
            "license": "RN259680",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "MS",
            "license": "R624608",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "901572",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN259680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; 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.