Active NPI
Rena Norman
- Contractor
- Forest Park, GA
National Provider Identifier
1184028185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 453589
- Practice address
- 6018 Old Dixie Hwy
Forest Park, GA 30297-3251 - Phone
- (404) 241-2323
- NPI assigned
- Oct 20, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 453589 | GA | Primary |
Addresses
Primary practice location
6018 Old Dixie Hwy
Forest Park, GA 30297-3251
Mailing address
6018 Old Dixie Hwy
Forest Park, GA 30297-3251
Phone (404) 241-2323
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 453589 | Other | GA | GA INSURANCE LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 453589 | GA | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413763200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413763200000",
"number": "1184028185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6018 OLD DIXIE HWY",
"city": "FOREST PARK",
"state": "GA",
"postal_code": "302973251",
"telephone_number": "404-241-2323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6018 OLD DIXIE HWY",
"city": "FOREST PARK",
"state": "GA",
"postal_code": "302973251",
"telephone_number": "404-241-2323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORMAN",
"first_name": "RENA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-20",
"last_updated": "2014-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "GA",
"license": "453589",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GA INSURANCE LICENSE",
"identifier": "453589",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Forest Park, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.