Individual provider Active NPI

Kerri Queen, MSN, FNP-C

  • Family Nurse Practitioner
  • Rome, GA
National Provider Identifier
1134588684
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN168114 Issued in GA
Practice address
36 Chateau CT SE
Rome, GA 30161-7264
Phone
(706) 233-9603
NPI assigned
Feb 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN168114 GA Primary

Addresses

Primary practice location

36 Chateau CT SE
Rome, GA 30161-7264

Mailing address

36 Chateau CT SE
Rome, GA 30161-7264
Phone (706) 233-9603

Other names 1

  • Kerri Whittenburg Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NC2 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

Enrollment IDStateProvider typePAC IDDetails
I20160226000838 GA Practitioner - Nurse Practitioner 8527363654 Reassigns benefits to 1 organization
I20230215002647 NC Practitioner - Nurse Practitioner 8527363654 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Urgent Care LLC CurrentSince Feb 1, 2022 Accepting new patients
Rural Urgent Care LLC CurrentSince Jan 14, 2021 Accepting new patients
Mainstreet and Kidsstreet of North Carolina PLLC CurrentSince Jan 24, 2023 Accepting new patients
Mainstreet and Kidsstreet of North Carolina PLLC CurrentSince Jan 24, 2023 Accepting new patients
Rural Urgent Care LLC CurrentSince Jan 14, 2021 Accepting new patients
New Horizons Treatment Center Inc. PastSince Dec 28, 2025 Accepting new patients

Locations

1500 1st Ave N
Unit 3
Birmingham, AL 35203
Phone (205) 545-5088

1408 Tallahassee Hwy
Ste Z
Bainbridge, GA 39819
Phone (229) 400-9033

25 Highland Xing S
Ellijay, GA 30540
Phone (706) 273-1954

130 James Ave
Locust, NC 28097
Phone (704) 271-3777

Organizations & group practices 6

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": "1455235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766448000000",
    "number": "1134588684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 CHATEAU CT SE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301617264",
            "telephone_number": "706-233-9603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 CHATEAU CT SE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301617264",
            "telephone_number": "706-233-9603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEEN",
        "first_name": "KERRI",
        "credential": "MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-12",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN168114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRI",
            "last_name": "WHITTENBURG",
            "credential": "MSN, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.