Individual provider Active NPI

Nicole Cristina Habibe Burgos, MD

  • Obstetrics & Gynecology Physician
  • Johns Creek, GA
National Provider Identifier
1215686936
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
111475 Issued in GA
Practice address
10692 Medlock Bridge Rd Ste 100a
Johns Creek, GA 30097-8497
Phone
(787) 903-4960
NPI assigned
Mar 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X FL
Obstetrics & Gynecology Physician 207V00000X 111475 GA Primary

Addresses

Primary practice location

10692 Medlock Bridge Rd Ste 100a
Johns Creek, GA 30097-8497

Mailing address

10692 Medlock Bridge Rd Ste 100a
Johns Creek, GA 30097-8497
Phone (404) 446-1286

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
111475GAMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1647820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1215686936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10692 MEDLOCK BRIDGE RD STE 100A",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300978497",
            "telephone_number": "404-446-1286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10692 MEDLOCK BRIDGE RD STE 100A",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300978497",
            "telephone_number": "787-903-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABIBE BURGOS",
        "first_name": "NICOLE",
        "middle_name": "CRISTINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-21",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "GA",
            "license": "111475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.