Individual provider Active NPI

Satoya Dubose

  • Family Nurse Practitioner
  • Laurinburg, NC
National Provider Identifier
1306214820
Registry record updated Feb 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5007966 Issued in NC
Practice address
1707 Berwick Dr Ste a
Laurinburg, NC 28352-5543
Phone
(910) 276-2439
NPI assigned
Sep 15, 2015
Last updated
Feb 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 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 5007966 NC Primary

Addresses

Primary practice location

1707 Berwick Dr Ste a
Laurinburg, NC 28352-5543

Mailing address

5351 Terry Rd
Clio, SC 29525-4235
Phone (864) 710-0351

Other identifiers 1

IdentifierTypeStateIssuer
1306214820MedicaidGA

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
I20180727002666 GA Practitioner - Nurse Practitioner 8022312438 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2658 Stonekey BND
Lithonia, GA 30058-4121

5885 Allison St
Unit 1003
Arvada, CO 80001-2601

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5007966NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Restore First Health Marietta LLC CurrentSince Oct 25, 2024 Accepting new patients
Restore First Health Riverdale LLC CurrentSince Nov 1, 2024 Accepting new patients
Duluth Regenerative and Joint Institute LLC CurrentSince Nov 1, 2024 Accepting new patients
Preferred Healthcare LLC CurrentSince Nov 19, 2025 Accepting new patients
DC Care PLLC Family Current Accepting new patients
Prime Regen Decatur CurrentSince Nov 1, 2024 Accepting new patients

Locations

2680 Lawrenceville Hwy
Ste 101
Decatur, GA 30033
Phone (470) 292-3820

3851 Postal Dr
Ste 200
Duluth, GA 30096
Phone (404) 919-5708

10680 Medlock Bridge Rd
Ste 204
Johns Creek, GA 30097
Phone (470) 292-3820

2550 Windy Hill Rd SE
Ste 115
Marietta, GA 30067
Phone (678) 580-2684

34 Upper Riverdale Rd SE
Ste 101
Riverdale, GA 30274
Phone (470) 292-3820

Organizations & group practices 6

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": "1442275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517788800000",
    "number": "1306214820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5351 TERRY RD",
            "city": "CLIO",
            "state": "SC",
            "postal_code": "295254235",
            "telephone_number": "864-710-0351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 BERWICK DR STE A",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525543",
            "telephone_number": "910-276-2439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "SATOYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-15",
        "last_updated": "2018-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5007966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306214820",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurinburg, NC

Sources for this page

Verify at the official NPI Registry.