Individual provider Active NPI

Rhondalynn Sharice Tolbert, NP-C

  • Family Nurse Practitioner
  • Chipley, FL
National Provider Identifier
1407413339
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
218115 Issued in GA
Practice address
1119 Iola Dr
Chipley, FL 32428-6302
Phone
(850) 260-2684
NPI assigned
May 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11007499 FL
Family Nurse Practitioner 363LF0000X 218115 GA Primary

Addresses

Primary practice location

1119 Iola Dr
Chipley, FL 32428-6302

Mailing address

4827 Macy Way
Ellenwood, GA 30294-2067
Phone (850) 260-2684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190830002574 GA Practitioner - Nurse Practitioner 0749519643 Reassigns benefits to 1 organization
I20230531000361 FL Practitioner - Nurse Practitioner 0749519643

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11007499FLMDFamily Nurse Practitioner
218115GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
V&R Rejuvenation Drip Bar LLC Family CurrentSince Sep 12, 2021 Accepting new patients
Millennium Health Partners, LLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1558915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1407413339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4827 MACY WAY",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302942067",
            "telephone_number": "850-260-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 IOLA DR",
            "city": "CHIPLEY",
            "state": "FL",
            "postal_code": "324286302",
            "telephone_number": "850-260-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLBERT",
        "first_name": "RHONDALYNN",
        "middle_name": "SHARICE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-27",
        "last_updated": "2021-09-07",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11007499",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "218115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chipley, FL

Sources for this page

Verify at the official NPI Registry.