Individual provider Active NPI

Korema Roshawn Brantley, FNP

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1245087667
Registry record updated Oct 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN263649 Issued in GA
Practice address
3350 Riverwood Pkwy SE Ste 1900
Atlanta, GA 30339-2066
Phone
(855) 212-2273
Fax
(629) 240-6003
NPI assigned
May 2, 2024
Last updated
Oct 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2026

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 RN263649 GA Primary

Addresses

Primary practice location

3350 Riverwood Pkwy SE Ste 1900
Atlanta, GA 30339-2066

Mailing address

5410 Maryland Way Ste 400
Brentwood, TN 37027-8087
Phone (855) 212-2273

Other practice location 1

103 Old School Cir
Guyton, GA 31312-5639
Phone (912) 572-8222

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
I20250217002017 GA Practitioner - Nurse Practitioner 0941720239 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Medical PC Nurse Practitioner CurrentSince Nov 6, 2024 Accepting new patients

Locations

22 Maple Ridge Dr
Cartersville, GA 30121
Phone (770) 606-8800

250 Skillman St
Ste 202
Brooklyn, NY 11205

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1714608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792627200000",
    "number": "1245087667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 MARYLAND WAY STE 400",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370278087",
            "telephone_number": "855-212-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 RIVERWOOD PKWY SE STE 1900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392066",
            "telephone_number": "855-212-2273",
            "fax_number": "629-240-6003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Old School Cir",
            "address_purpose": "LOCATION",
            "city": "Guyton",
            "state": "GA",
            "postal_code": "313125639",
            "country_code": "US",
            "telephone_number": "912-572-8222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANTLEY",
        "first_name": "KOREMA",
        "middle_name": "ROSHAWN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-02",
        "last_updated": "2026-10-22",
        "certification_date": "2026-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN263649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.