Individual provider Active NPI

Cynthia Louise Landers, FNP-C

  • Family Nurse Practitioner
  • Rome, GA
National Provider Identifier
1205399474
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN142457 Issued in GA
Practice address
304 Turner McCall Blvd SW
Rome, GA 30165-5621
Phone
(706) 509-6110
NPI assigned
Apr 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X RN142457 GA
Family Nurse Practitioner 363LF0000X RN142457 GA Primary

Addresses

Primary practice location

304 Turner McCall Blvd SW
Rome, GA 30165-5621

Mailing address

55 Surrey TRL SE
Rome, GA 30161-5946
Phone (706) 936-0077

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
I20190815002941 GA Practitioner - Nurse Practitioner 2466789276 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chattooga River Physicians, LLCGroup PAC ID 8820443575, 19 clinicians
Etowah Emergency Physicians, LLCGroup PAC ID 1456635697, 29 clinicians

Practice addresses (Care Compare)

13583 Hwy 27
Trion, GA 30753-1511
Phone (706) 238-8360

2360 Rockmart Hwy
Cedartown, GA 30125-6029
Phone (770) 748-2500

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
24 On Physicians, PC CurrentSince Jun 15, 2019 Accepting new patients
Etowah Emergency Physicians, LLC Emergency Medicine CurrentSince Apr 15, 2019 Accepting new patients
Chattooga River Physicians, LLC Emergency Medicine CurrentSince Dec 5, 2023 Accepting new patients
24 On Physicians, P.C. CurrentSince Jun 15, 2019 Accepting new patients

Locations

13000 Deerfield Pkwy
Ste 100
Alpharetta, GA 30004

2360 Rockmart Hwy
Cedartown, GA 30125
Phone (770) 748-2500

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

304 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 506-5000

13583 Highway 27
Trion, GA 30753
Phone (706) 238-8360

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1205399474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 SURREY TRL SE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301615946",
            "telephone_number": "706-936-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 TURNER MCCALL BLVD SW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301655621",
            "telephone_number": "706-509-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDERS",
        "first_name": "CYNTHIA",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-12",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "RN142457",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN142457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

Verify at the official NPI Registry.