Roseylee Kuriakose

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN220165 Issued in GA

Practice address

367 Athens Hwy
Loganville, GA 30052-2204

Phone

(678) 466-6760

NPI assigned

Oct 2, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  GA

  Medicare reassignment

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1124625231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 ATHENS HWY",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 ATHENS HWY",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522204",
            "telephone_number": "678-466-6760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURIAKOSE",
        "first_name": "ROSEYLEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN220165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RN220165",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne L Kole, MPT
• Wojciech Jan Konopka, PT, MPT
• Terri Kopp, NP
• Kotzqualitydental LLC
• Ia Y Kue, D.O.
• Felicia Kwashie
• L & W Legacy Enterprises
• Juan Carlos Lacayo, M.D.
• Monique Laguerre
• Brandon Lai, PA-C

• Adult Health Nurse Practitioner in Loganville, GA
• Providers in Loganville, GA by specialty
• Adult Health Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.