Individual provider Active NPI

Asmita Raut

  • Family Nurse Practitioner
  • Clarkston, GA
National Provider Identifier
1164269346
Registry record updated Jul 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
315662 Issued in GA
Practice address
3660 Market St
Clarkston, GA 30021-1246
Phone
(470) 355-7896
NPI assigned
Jul 13, 2024
Last updated
Jul 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2024

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 315662 GA Primary

Addresses

Primary practice location

3660 Market St
Clarkston, GA 30021-1246

Mailing address

621 Catamount Way SW
Lilburn, GA 30047-8952
Phone (510) 829-7773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
315662GAMDFamily Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: asmita.raut.1@20067.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1720828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720828800000",
    "number": "1164269346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 CATAMOUNT WAY SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300478952",
            "telephone_number": "510-829-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 MARKET ST",
            "city": "CLARKSTON",
            "state": "GA",
            "postal_code": "300211246",
            "telephone_number": "470-355-7896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUT",
        "first_name": "ASMITA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-13",
        "last_updated": "2024-07-13",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "315662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.