Nedege Raybourne

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F04180532 Issued in GA

Practice address

30 Cranbrook Way
Covington, GA 30016-9065

Phone

(470) 774-0789

NPI assigned

Aug 26, 2018

Last updated

Aug 26, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Nedege Richaard Other name

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

Merit-based Incentive Payment System (MIPS)

Final score

25.45 of 100Reported as individual

Quality

0

Promoting interoperability

0

Improvement activities

0

Cost

84.83

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Georgia Mso LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1952196164
  Medicare reassignment NPD
• Hardy Renew Wellness,LLC

  • Internal Medicine Physician
  • Marietta, GA
  • NPI 1952914368
  Medicare reassignment NPD
• Medical Director Services PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Princess Anne, MD
  • NPI 1871955807

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1535241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535241600000",
    "number": "1386125516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 CRANBROOK WAY",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300169065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 CRANBROOK WAY",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300169065",
            "telephone_number": "470-774-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBOURNE",
        "first_name": "NEDEGE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-26",
        "last_updated": "2018-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN186313",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F04180532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NEDEGE",
            "last_name": "RICHAARD",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ransom Billing and Credentialing Company
• Mary Lashon Ransom
• Lilka Finley Raphael, R.PH.
• Kareemah Rashied, FNP-BC, APRN
• Karen Yvette Ray
• Raymir Behavioral Health LLC
• Rcog Cancer Center LLC - Newton
• Reach Healthcare Services, LLC
• Zandria Redding
• Anitha R Reddy, D.M.D

• Family Nurse Practitioner in Covington, GA
• Providers in Covington, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.