Individual provider Active NPI

Denise Coultes, NP-C

  • Critical Care Medicine Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1134257686
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine Nurse PractitionerTaxonomy code 363LC0200X
License
RN126619NP Issued in GA
Practice address
59 Executive Park South NE
Suite 2090
Atlanta, GA 30329-2208
Phone
(404) 778-6296
Fax
(404) 778-7208
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Nurse Practitioner 363LC0200X RN126619NP GA Primary

Addresses

Primary practice location

59 Executive Park South NE
Suite 2090
Atlanta, GA 30329-2208

Mailing address

59 Executive Park South NE
Suite 2090
Atlanta, GA 30329-2208
Phone (404) 778-6296

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
I20190615000073 GA Practitioner - Nurse Practitioner 5799766903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Choa Hospital Based, LLCGroup PAC ID 4688812498, 97 clinicians

Practice addresses (Care Compare)

1400 Tullie Rd NE
Suite 210
Atlanta, GA 30329-2309
Phone (404) 785-0122

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN126619NPGAMDCritical Care Medicine Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Egleston Pediatric Group Current Accepting new patients
Choa Multispecialty, LLC CurrentSince Mar 17, 2019 Accepting new patients
Choa Hospital Based, LLC CurrentSince Mar 17, 2019 Accepting new patients
Children'S Orthopaedics of Atlanta P.C. PastSince Mar 1, 2013 Accepting new patients

Locations

1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525

1405 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 785-1112

1400 Tullie Rd NE
Ste 210
Atlanta, GA 30329
Phone (404) 785-0122

2270 Duluth Hwy
Ste 100
Duluth, GA 30097

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1134257686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 EXECUTIVE PARK SOUTH NE",
            "address_2": "SUITE 2090",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292208",
            "telephone_number": "404-778-6296",
            "fax_number": "404-778-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 EXECUTIVE PARK SOUTH NE",
            "address_2": "SUITE 2090",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292208",
            "telephone_number": "404-778-6296",
            "fax_number": "404-778-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTES",
        "first_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "GA",
            "license": "RN126619NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.