Individual provider Active NPI

Nakisha Maria Christian

  • Acute Care Nurse Practitioner
  • Riverdale, GA
National Provider Identifier
1447805551
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
272638 Issued in GA
Practice address
11 Upper Riverdale Rd
Riverdale, GA 30274
Phone
(770) 897-7109
NPI assigned
Aug 6, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 272638 GA Primary

Addresses

Primary practice location

11 Upper Riverdale Rd
Riverdale, GA 30274

Mailing address

1596 Cleveland Ave Apt 301
East Point, GA 30344-3233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 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
I20201223000973 MD Practitioner - Nurse Practitioner 4385976836
I20231204003320 DC Practitioner - Nurse Practitioner 4385976836 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
272638GAMDAcute Care Nurse Practitioner

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": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1447805551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1596 CLEVELAND AVE APT 301",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 UPPER RIVERDALE RD",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "30274",
            "telephone_number": "770-897-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIAN",
        "first_name": "NAKISHA",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "272638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

Verify at the official NPI Registry.