Individual provider Active NPI

Feruza Mustafayevna Bezgunova

  • Student in an Organized Health Care Education/Training Program
  • Lawrenceville, GA
National Provider Identifier
1376303974
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
665 Duluth Hwy Ste 501
Lawrenceville, GA 30046-8709
Phone
(678) 312-0491
NPI assigned
Mar 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

665 Duluth Hwy Ste 501
Lawrenceville, GA 30046-8709

Mailing address

195 Foe Creek CT
Roswell, GA 30076-4646
Phone (720) 207-7371

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240604000661 GA Order and Referring Only - Family PracticePractitioner - Family Practice 9436691664

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1710892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1376303974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 FOE CREEK CT",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764646",
            "telephone_number": "720-207-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 DULUTH HWY STE 501",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468709",
            "telephone_number": "678-312-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEZGUNOVA",
        "first_name": "FERUZA",
        "middle_name": "MUSTAFAYEVNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-20",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.