Individual provider Active NPI

Rachel Dyches, DNP, FNP-C

  • Family Nurse Practitioner
  • Suwanee, GA
National Provider Identifier
1174938047
Registry record updated Jun 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18900 Issued in SC
Practice address
4245 Johns Creek Pkwy Ste a
Suwanee, GA 30024-9122
Phone
(678) 990-3962
Fax
(678) 840-3777
NPI assigned
Jun 30, 2014
Last updated
Jun 20, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 18900 SC Primary
Neonatal Intensive Care Registered Nurse 163WN0002X 104039 SC

Addresses

Primary practice location

4245 Johns Creek Pkwy Ste a
Suwanee, GA 30024-9122

Mailing address

4245 Johns Creek Pkwy Ste a
Suwanee, GA 30024-9122
Phone (803) 308-1983

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 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
I20141026000005 SC Practitioner - Nurse Practitioner 2961623418
I20170713001940 GA Practitioner - Nurse Practitioner 2961623418 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
104039SCMDNeonatal Intensive Care Registered Nurse
18900SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Jun 26, 2017 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Jun 26, 2017 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Sleepmed Inc. Past Accepting new patients

Locations

5150 Stilesboro Rd NW
Ste 120
Kennesaw, GA 30152
Phone (678) 354-0230

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

55 Whitcher St NE
Ste 160
Marietta, GA 30060
Phone (770) 590-4180

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592611200000",
    "number": "1174938047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4245 JOHNS CREEK PKWY STE A",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300249122",
            "telephone_number": "803-308-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 JOHNS CREEK PKWY STE A",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300249122",
            "telephone_number": "678-990-3962",
            "fax_number": "678-840-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYCHES",
        "first_name": "RACHEL",
        "credential": "DNP, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2020-06-20",
        "certification_date": "2020-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "18900",
            "primary": true
        },
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "SC",
            "license": "104039",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

Verify at the official NPI Registry.