Individual provider Active NPI

Marie Carline Dorleus, FNP

  • Family Nurse Practitioner
  • Kennesaw, GA
National Provider Identifier
1396285466
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
296625 Issued in GA
Practice address
2782 Cobb Pkwy NW
Kennesaw, GA 30152-3472
Phone
(770) 420-1092
NPI assigned
Mar 8, 2017
Last updated
Jun 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9328002 FL
Family Nurse Practitioner 363LF0000X ARNP9328002 FL
Family Nurse Practitioner 363LF0000X 11978 CT
Family Nurse Practitioner 363LF0000X 296625 GA Primary

Addresses

Primary practice location

2782 Cobb Pkwy NW
Kennesaw, GA 30152-3472

Mailing address

2782 Cobb Pkwy NW
Kennesaw, GA 30152-3472
Phone (770) 420-1092

Other practice location 1

323 Cromwell Ave
Rocky Hill, CT 06067-1801
Phone (860) 563-9393

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
I20210806000069 GA Practitioner - Nurse Practitioner 5092084996

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11978CTMDFamily Nurse Practitioner
9328002FLMDFamily Nurse Practitioner
ARNP9328002FLMDFamily Nurse Practitioner
296625GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Voe Consulting LLC PastSince Sep 17, 2023 Accepting new patients

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": "1488931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1396285466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2782 COBB PKWY NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523472",
            "telephone_number": "770-420-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2782 COBB PKWY NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523472",
            "telephone_number": "770-420-1092"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "323 Cromwell Ave",
            "address_purpose": "LOCATION",
            "city": "Rocky Hill",
            "state": "CT",
            "postal_code": "060671801",
            "country_code": "US",
            "telephone_number": "860-563-9393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORLEUS",
        "first_name": "MARIE",
        "middle_name": "CARLINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-08",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "9328002",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9328002",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "11978",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "296625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.