Individual provider Active NPI

Rosina Ibeth Ellington, ARNP

  • Nurse Practitioner
  • Fayetteville, GA
National Provider Identifier
1184873549
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN186595 Issued in GA
Practice address
1255 Highway 54 W
Fayetteville, GA 30214-4526
Phone
(770) 719-7256
Fax
(770) 719-7378
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN186595 GA Primary

Addresses

Primary practice location

1255 Highway 54 W
Fayetteville, GA 30214-4526

Mailing address

165 Cottonbelle Dr
Stockbridge, GA 30281-9146
Phone (770) 389-7127

Other identifiers 1

IdentifierTypeStateIssuer
595097960AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20081027000492 GA Practitioner - Nurse Practitioner 2264590868 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Specialty Hospital Billing LLCGroup PAC ID 4183986490, 252 clinicians

Practice addresses (Care Compare)

1133 Eagles Landing Pkwy
Stockbridge, GA 30281-5085
Phone (678) 604-1000

Hospital & facility affiliations

  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
  • Northside Hospital Hospital, Atlanta, GA, CCN 110161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Healthcare Inc CurrentSince Nov 4, 2013 Accepting new patients
Piedmont Specialty Hospital Billing LLC CurrentSince Apr 1, 2018 Accepting new patients
Southeastern Wound Care Services, Inc Past Accepting new patients

Locations

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

1984 Peachtree Rd NW
Ste 205
Atlanta, GA 30309

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

1133 Eagles Landing Pkwy
Stockbridge, GA 30281
Phone (678) 604-1000

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519776000000",
    "number": "1184873549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 COTTONBELLE DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819146",
            "telephone_number": "770-389-7127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 HIGHWAY 54 W",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144526",
            "telephone_number": "770-719-7256",
            "fax_number": "770-719-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGTON",
        "first_name": "ROSINA",
        "middle_name": "IBETH",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2018-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN186595",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "595097960A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.