Anslie Prudhomme

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN273932 Issued in GA

Practice address

4364 Burnleigh Chase NE
Roswell, GA 30075-1956

Phone

(904) 545-0747

NPI assigned

Jun 4, 2018

Last updated

Oct 9, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

KCP EnterprisesGroup PAC ID 7517303613, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• KCP Enterprises

  dba Elite Medical and Rehab

  • Physical Medicine & Rehabilitation Physician
  • Morrow, GA
  • NPI 1043679418
  Medicare reassignment Care Compare group NPD
• Beyond Mental Health Wellness LLC

  • Anesthesiology Physician
  • Woodstock, GA
  • NPI 1174232151
  NPD (past)

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1285126391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4364 BURNLEIGH CHASE NE",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300751956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4364 BURNLEIGH CHASE NE",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300751956",
            "telephone_number": "904-545-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUDHOMME",
        "first_name": "ANSLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-04",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN273932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Primeone Healthcare Services, LLC
• Priority Emergency Medical Services LLC
• Diane M Proffitt, RPH
• Prosource Surgical Assisting, LLC
• Patricia Proveaux, FNP-BC
• Brad Prybis, MD
• Psychiatry and Wellness of Georgia, LLC
• Psychology Innovations, P.C.
• PT Solutions of Acworth, LLC
• Publix Super Markets Inc (Publix Pharmacy #0086)

• Family Nurse Practitioner in Roswell, GA
• Providers in Roswell, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.