Individual provider Active NPI

Tabria Colston, FNP-C

  • Family Nurse Practitioner
  • Snellville, GA
National Provider Identifier
1417561002
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN176249 Issued in GA
Practice address
2386 Clower St Ste C105
Snellville, GA 30078-6107
Phone
(678) 344-0334
Fax
(678) 344-0343
NPI assigned
Sep 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN176249 GA Primary

Addresses

Primary practice location

2386 Clower St Ste C105
Snellville, GA 30078-6107

Mailing address

2386 Clower St Ste C105
Snellville, GA 30078-6107
Phone (678) 344-0344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Kidney Clinic CurrentSince Mar 24, 2024 Accepting new patients

Locations

2386 Clower St
Ste C105
Snellville, GA 30078
Phone (678) 344-0334

Interoperability endpoints

  • Direct secure messaging: tabria.colston@direct.davitaphysiciansolutions.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1417561002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2386 CLOWER ST STE C105",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786107",
            "telephone_number": "678-344-0344",
            "fax_number": "678-344-0343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2386 CLOWER ST STE C105",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786107",
            "telephone_number": "678-344-0334",
            "fax_number": "678-344-0343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLSTON",
        "first_name": "TABRIA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN176249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.