Active NPI
Theodora Lane Vaile, N.P.
- Family Nurse Practitioner
- Atlanta, GA
National Provider Identifier
1205163797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RNO77746
- Practice address
- 325 Candler Rd SE
Atlanta, GA 30317-3433 - Phone
- (404) 288-2273
- NPI assigned
- Nov 4, 2009
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RNO77746 | GA | Primary |
Addresses
Primary practice location
325 Candler Rd SE
Atlanta, GA 30317-3433
Mailing address
325 Candler Rd SE
Atlanta, GA 30317-3433
Phone (404) 288-2273
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
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RNO77746 | GA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1257292800000",
"number": "1205163797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 CANDLER RD SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303173433",
"telephone_number": "404-288-2273"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 CANDLER RD SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303173433",
"telephone_number": "404-288-2273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAILE",
"first_name": "THEODORA",
"middle_name": "LANE",
"name_prefix": "Ms.",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-04",
"last_updated": "2009-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RNO77746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.