Organization Active NPI

Magnolia Womens Health LLC

  • Women's Health Nurse Practitioner
  • Dalton, GA
National Provider Identifier
1114682648
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
Legal business name
MAGNOLIA WOMENS HEALTH LLC
Practice address
303 W Waugh St
Dalton, GA 30720-3116
Phone
(706) 529-8076
NPI assigned
Oct 31, 2021
Last updated
Jul 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Authorized official

Name
Rachel EasterwoodNPI 1053913160
Title
Owner
Phone
(770) 401-0953

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LW0102X Primary

Addresses

Primary practice location

303 W Waugh St
Dalton, GA 30720-3116

Mailing address

303 W Waugh St
Dalton, GA 30720-3116
Phone (706) 529-8076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220105000899 GA Part B Supplier - Clinic/Group Practice 9830580687 Receives reassigned benefits from 4 practitioners
Practice locations: Dalton, GA

National Provider Directory

National Provider Directory

Locations

220 W Morris St
Dalton, GA 30720
Phone (770) 401-0953

303 W Waugh St
Dalton, GA 30720
Phone (706) 529-8076

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1635638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1114682648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 W WAUGH ST",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203116",
            "telephone_number": "706-529-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W WAUGH ST",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307203116",
            "telephone_number": "706-529-8076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA WOMENS HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-31",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "EASTERWOOD",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-401-0953"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Women's Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.