Individual provider Active NPI

Joanne Talley, RD, LD, CDE

  • Registered Dietitian
  • Fayetteville, GA
National Provider Identifier
1245490549
Registry record updated Jun 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
000970 Issued in GA
Practice address
105 Carnegie PL
Ste 103
Fayetteville, GA 30214-3980
Phone
(770) 716-7999
NPI assigned
Jun 11, 2008
Last updated
Jun 11, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 000970 GA Primary

Addresses

Primary practice location

105 Carnegie PL
Ste 103
Fayetteville, GA 30214-3980

Mailing address

105 Carnegie PL
Ste 103
Fayetteville, GA 30214-3980
Phone (770) 716-7999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090520000224 GA Practitioner - Registered Dietitian Or Nutrition Professional 4082763172 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000970GAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Group, P.C. CurrentSince May 31, 2022 Accepting new patients
Freedom Medical Solutions, Inc. PastSince Nov 19, 2007 Accepting new patients

Locations

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

105 Carnegie Pl
Ste 103
Fayetteville, GA 30214
Phone (770) 716-7999

1035 Southcrest Dr
Ste 200
Stockbridge, GA 30281
Phone (770) 474-5302

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

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": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1245490549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 CARNEGIE PL",
            "address_2": "STE 103",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143980",
            "telephone_number": "770-716-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CARNEGIE PL",
            "address_2": "STE 103",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143980",
            "telephone_number": "770-716-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TALLEY",
        "first_name": "JOANNE",
        "credential": "RD, LD, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "GA",
            "license": "000970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.