Individual provider Active NPI

Ramanda Raquel Dace, FNP-C

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1104492586
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN291913 Issued in GA
Practice address
650 North Ave NE Ste S204
Atlanta, GA 30308-2705
Phone
(888) 663-6331
NPI assigned
May 27, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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 RN291913 GA Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X RN291913 GA

Addresses

Primary practice location

650 North Ave NE Ste S204
Atlanta, GA 30308-2705

Mailing address

650 North Ave NE Ste S204
Atlanta, GA 30308-2705
Phone (888) 663-6331

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
I20210708001325 GA Practitioner - Nurse Practitioner 4880096247 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Physicians Group, LLCGroup PAC ID 6709294804, 13 clinicians

Practice addresses (Care Compare)

650 N Ave NE
S204
Atlanta, GA 30308-2705
Phone (404) 504-6554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN291913GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Physicians Group, LLC Single Specialty CurrentSince May 1, 2025 Accepting new patients
T Douglas Gurley MD LLC Single Specialty CurrentSince Jan 13, 2025 Accepting new patients

Locations

650 North Ave NE
#S204
Atlanta, GA 30308
Phone (404) 504-6554

659 Auburn Ave NE
Ste 156
Atlanta, GA 30312
Phone (404) 888-0228

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": "1622073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1104492586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 NORTH AVE NE STE S204",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082705",
            "telephone_number": "888-663-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 NORTH AVE NE STE S204",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303082705",
            "telephone_number": "888-663-6331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DACE",
        "first_name": "RAMANDA",
        "middle_name": "RAQUEL",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-27",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN291913",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN291913",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.