Individual provider Active NPI

Sevilya R Bezginova, FNP

  • Primary Care Nurse Practitioner
  • Roswell, GA
National Provider Identifier
1124696703
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN251545 Issued in GA
Practice address
125 Carriage Station Cir
Roswell, GA 30075-4654
Phone
(404) 647-3437
NPI assigned
Jun 11, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN251545 GA Primary

Addresses

Primary practice location

125 Carriage Station Cir
Roswell, GA 30075-4654

Mailing address

125 Carriage Station Cir
Roswell, GA 30075-4654
Phone (404) 647-3437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220513000059 GA Practitioner - Nurse Practitioner 7719364736 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy and Asthma Consultants, P.C. CurrentSince Jul 15, 2023 Accepting new patients
Wellstar Medical Group, LLC CurrentSince May 15, 2022 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince May 15, 2022 Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

5555 Ptree Dunwoody Rd NE
Ste 325
Sandy Springs, GA 30342
Phone (404) 255-9286

Organizations & group practices 4

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": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1124696703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 CARRIAGE STATION CIR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300754654",
            "telephone_number": "404-647-3437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 CARRIAGE STATION CIR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300754654",
            "telephone_number": "404-647-3437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEZGINOVA",
        "first_name": "SEVILYA",
        "middle_name": "R",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-06-11",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN251545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.