Individual provider Active NPI

Alexandra Ivester, NP-C

  • Women's Health Nurse Practitioner
  • Toccoa, GA
National Provider Identifier
1285627463
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
159202 Issued in GA
Practice address
274 Big a Road
Toccoa, GA 30577-6002
Phone
(706) 886-3169
Fax
(706) 282-5371
NPI assigned
Aug 24, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 159202 GA Primary

Addresses

Primary practice location

274 Big a Road
Toccoa, GA 30577-6002

Mailing address

274 Big a Road
Toccoa, GA 30577-6002
Phone (706) 886-3169

Other identifiers 1

IdentifierTypeStateIssuer
676431619ABCMedicaidGA

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
159202GAMDWomen's Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1285627463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "274 BIG A ROAD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305776002",
            "telephone_number": "706-886-3169",
            "fax_number": "706-282-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "274 BIG A ROAD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "305776002",
            "telephone_number": "706-886-3169",
            "fax_number": "706-282-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVESTER",
        "first_name": "ALEXANDRA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "159202",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "676431619ABC",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toccoa, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; 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.