Active NPI
Regine G Vincent, NP
- Primary Care Nurse Practitioner
- Atlanta, GA
National Provider Identifier
1346800257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- RN180691
- Practice address
- 3750 Peachtree Rd NE
Atlanta, GA 30319-1385 - Phone
- (404) 261-6611
- NPI assigned
- Jun 13, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | RN180691 | GA | Primary |
Addresses
Primary practice location
3750 Peachtree Rd NE
Atlanta, GA 30319-1385
Mailing address
3750 Peachtree Rd NE
Atlanta, GA 30319-1385
Phone (404) 261-6611
Other practice location 1
4151 Memorial Dr
Decatur, GA 30032-1504
Phone (404) 294-1991
Other practice location 2
3113 Washington Rd
East Point, GA 30344-5414
Phone (404) 768-4210
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)
- Not enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN180691 | GA | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560384000000",
"number": "1346800257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3750 PEACHTREE RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303191385",
"telephone_number": "404-261-6611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3750 PEACHTREE RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303191385",
"telephone_number": "404-261-6611"
}
],
"practiceLocations": [
{
"address_1": "4151 Memorial Dr",
"address_purpose": "LOCATION",
"city": "Decatur",
"state": "GA",
"postal_code": "300321504",
"country_code": "US",
"telephone_number": "404-294-1991",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3113 Washington Rd",
"address_purpose": "LOCATION",
"city": "East Point",
"state": "GA",
"postal_code": "303445414",
"country_code": "US",
"telephone_number": "404-768-4210",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VINCENT",
"first_name": "REGINE",
"middle_name": "G",
"credential": "NP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-13",
"last_updated": "2019-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": "GA",
"license": "RN180691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.