Individual provider Active NPI

Chandra Charlotin, APRN, FNP-C

  • Family Nurse Practitioner
  • Tucker, GA
National Provider Identifier
1326506932
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN219470 Issued in GA
Practice address
4424 Hugh Howell Rd Ste D
Tucker, GA 30084-4905
Phone
(404) 692-4466
Fax
(415) 252-7176
NPI assigned
Mar 4, 2019
Last updated
Jun 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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 RN219470 GA Primary

Addresses

Primary practice location

4424 Hugh Howell Rd Ste D
Tucker, GA 30084-4905

Mailing address

1 Embarcadero Ctr FL 19
San Francisco, CA 94111-3628

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
I20191202002324 GA Practitioner - Nurse Practitioner 5698108819 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Southern Crescent Medical Center, LLCGroup PAC ID 9032541289, 2 clinicians

Practice addresses (Care Compare)

3579 Hwy 138 SE
Suite 103
Stockbridge, GA 30281-4127
Phone (770) 629-4374

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN219470GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Crescent Medical Center, LLC CurrentSince Jan 19, 2022 Accepting new patients

Locations

3579 Highway 138 SE
Ste 103
Stockbridge, GA 30281
Phone (770) 629-4374

Organizations & group practices 1

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": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1326506932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR FL 19",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113628",
            "fax_number": "415-252-7176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4424 HUGH HOWELL RD STE D",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844905",
            "telephone_number": "404-692-4466",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLOTIN",
        "first_name": "CHANDRA",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-04",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN219470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

Verify at the official NPI Registry.