Individual provider Active NPI

Rose Senge Kombe, FNP-C

  • Family Nurse Practitioner
  • Ellenwood, GA
National Provider Identifier
1285169185
Registry record updated Jan 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN193760 Issued in GA
Practice address
211 Fairview Rd
Ellenwood, GA 30294-2721
Phone
(678) 289-6747
Fax
(678) 289-6750
NPI assigned
Apr 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN193760 GA Primary

Addresses

Primary practice location

211 Fairview Rd
Ellenwood, GA 30294-2721

Mailing address

211 Fairview Rd
Ellenwood, GA 30294-2721
Phone (678) 289-6747

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
I20180511000687 GA Practitioner - Nurse Practitioner 2961766340 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Joseph'S Mercy Care Services IncGroup PAC ID 9931191525, 23 clinicians

Practice addresses (Care Compare)

275 Pryor St SW
Atlanta, GA 30303-3638
Phone (678) 843-8840

424 Decatur St SE
Atlanta, GA 30312-1848
Phone 67884386008537

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Meridian Education Resource Group, Inc. CurrentSince Aug 26, 2022 Accepting new patients
Saint Joseph'S Mercy Care Services, Inc. Current Accepting new patients
Meridian Education Resource Group, Inc. CurrentSince Aug 26, 2022 Accepting new patients
Saint Joseph'S Mercy Care Services Inc Current Accepting new patients
Saint Joseph'S Mercy Care Services, Inc. CurrentSince Sep 1, 2024 Accepting new patients
Saint Joseph'S Mercy Care Services Inc CurrentSince Sep 1, 2024 Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients

Locations

1300 Joseph E Boone Blvd NW
Atlanta, GA 30314
Phone (404) 952-1201

1401 Hosea Williams Dr SE
Atlanta, GA 30317
Phone (404) 373-2926

1353 George W Brumley Way SE
Atlanta, GA 30317

1976 Flat Shoals Rd SE
Ste B
Atlanta, GA 30316
Phone (404) 952-1201

424 Decatur St SE
Atlanta, GA 30312
Phone (678) 843-8500

5134 Peachtree Rd
Chamblee, GA 30341
Phone (678) 872-7100

Organizations & group practices 8

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": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516665600000",
    "number": "1285169185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 FAIRVIEW RD",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942721",
            "telephone_number": "678-289-6747",
            "fax_number": "678-289-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 FAIRVIEW RD",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942721",
            "telephone_number": "678-289-6747",
            "fax_number": "678-289-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMBE",
        "first_name": "ROSE",
        "middle_name": "SENGE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-28",
        "last_updated": "2018-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN193760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenwood, GA

Sources for this page

Verify at the official NPI Registry.