Octavia Moore Hedge, FNP-BC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

RN-147913-NP Issued in GA

Practice address

1707 Blair Bridge Rd
Austell, GA 30168-5537

Phone

(678) 945-0700

NPI assigned

Oct 1, 2019

Last updated

Nov 29, 2019By the provider in NPPES

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 names 1

• Octavia Moore-Hedge Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574985600000",
    "number": "1174164289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8601 BALDWIN PKWY STE 100",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301345626",
            "telephone_number": "678-948-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 BLAIR BRIDGE RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301685537",
            "telephone_number": "678-945-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDGE",
        "first_name": "OCTAVIA",
        "middle_name": "MOORE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-01",
        "last_updated": "2019-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN-147913-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OCTAVIA",
            "last_name": "MOORE-HEDGE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jon H Haynes, DDS
• Marius Haynes, MA
• Healthy Living Home Care
• Elizabeth Laura Heard, PA-C
• Heart to Heart Companion
• Gale Octavia Height
• John W Heisler, PA
• Kimberly Coley Henderson, PHARM.D
• Lauren I Henderson, M.D.
• Amanda Hendricks

• Primary Care Nurse Practitioner in Austell, GA
• Providers in Austell, GA by specialty
• Primary Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2019; 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.