Individual provider Active NPI

Natividad Jesusa Balderian Guevarra, NP

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1447518956
Registry record updated May 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN195137 Issued in GA
Practice address
304 Masons Creek Cir
Atlanta, GA 30350-2547
Phone
(404) 702-3722
NPI assigned
May 3, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2012

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 RN195137 GA Primary

Addresses

Primary practice location

304 Masons Creek Cir
Atlanta, GA 30350-2547

Mailing address

304 Masons Creek Cir
Atlanta, GA 30350-2547
Phone (404) 702-3722

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
I20120611000320 GA Practitioner - Nurse Practitioner 4486818101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metro Atlanta Diagnostics LLCGroup PAC ID 5193953719, 4 clinicians

Practice addresses (Care Compare)

4535 Winters Chapel Rd
Suite B
Atlanta, GA 30360-2705
Phone (770) 285-7246

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN195137GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Atlanta Diagnostics LLC CurrentSince May 1, 2015 Accepting new patients

Locations

3161 Howell Mill Rd NW
Ste 430
Atlanta, GA 30327
Phone (770) 285-7246

4535 Winters Chapel Rd
#B
Doraville, GA 30360
Phone (678) 580-1862

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": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1447518956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 MASONS CREEK CIR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303502547",
            "telephone_number": "404-702-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 MASONS CREEK CIR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303502547",
            "telephone_number": "404-702-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUEVARRA",
        "first_name": "NATIVIDAD JESUSA",
        "middle_name": "BALDERIAN",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN195137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.