Individual provider Active NPI

Sara Elizabeth Bobo, NP

  • Nurse Practitioner
  • Canton, GA
National Provider Identifier
1346025749
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN269980 Issued in GA
Practice address
15 Reinhardt College Pkwy Ste 100
Canton, GA 30114-5259
Phone
(770) 704-6988
NPI assigned
Aug 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X RN269980 GA
Internal Medicine Physician 207R00000X RN269980 GA
Nurse Practitioner 363L00000X RN269980 GA Primary

Addresses

Primary practice location

15 Reinhardt College Pkwy Ste 100
Canton, GA 30114-5259

Mailing address

122 Oakview Psge
Canton, GA 30114-1800
Phone (678) 389-0858

Other practice location 1

460 Northside Cherokee Blvd
Canton, GA 30115-8016
Phone (770) 224-1000

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
I20231205003216 GA Practitioner - Nurse Practitioner 8820447642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Piedmont Medical Care CorporationGroup PAC ID 6002802220, 368 clinicians

Practice addresses (Care Compare)

15 Reinhardt College Pkwy
Suite 100
Canton, GA 30114-5259
Phone (770) 704-6988

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Medical Care Corporation Family Medicine CurrentSince Nov 1, 2023 Accepting new patients

Locations

2727 Paces Ferry Rd SE
Ste 1-1100
Atlanta, GA 30339
Phone (470) 271-3421

105 Collier Rd NW
Ste 5020
Atlanta, GA 30309
Phone (404) 350-3860

15 Reinhardt College Pkwy
Ste 100
Canton, GA 30114
Phone (770) 479-1985

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1346025749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 OAKVIEW PSGE",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301141800",
            "telephone_number": "678-389-0858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 REINHARDT COLLEGE PKWY STE 100",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145259",
            "telephone_number": "770-704-6988"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "460 Northside Cherokee Blvd",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301158016",
            "country_code": "US",
            "telephone_number": "770-224-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOBO",
        "first_name": "SARA",
        "middle_name": "ELIZABETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "RN269980",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "RN269980",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN269980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

Verify at the official NPI Registry.