Active NPI
Dana Noel Rudisill
- Gerontology Nurse Practitioner
- Atlanta, GA
National Provider Identifier
1457079709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- NP311059
- Practice address
- 95 Collier Rd NW Ste 4075
Atlanta, GA 30309-1751 - Phone
- (404) 355-3200
- NPI assigned
- Aug 22, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | NP311059 | GA | Primary |
| Acute Care Nurse Practitioner | 363LA2100X | RN311059 | GA |
Addresses
Primary practice location
95 Collier Rd NW Ste 4075
Atlanta, GA 30309-1751
Mailing address
199 14TH St NE Apt 2109
Atlanta, GA 30309-3690
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230711000491 | GA | Practitioner - Nurse Practitioner | 7416316302 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN311059 | GA | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| City of Hope Medical Group of Georgia LLC | Current | Accepting new patients |
Locations
600 Celebrate Life Pkwy
Newnan, GA 30265
Phone (404) 844-8334
62742 Collections Ctr Dr
Chicago, IL 60693
Interoperability endpoints
- drudisill237370@cityofhope.direct-ci.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": "1661126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785715200000",
"number": "1457079709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "199 14TH ST NE APT 2109",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303093690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 COLLIER RD NW STE 4075",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303091751",
"telephone_number": "404-355-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDISILL",
"first_name": "DANA",
"middle_name": "NOEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-22",
"last_updated": "2026-08-03",
"certification_date": "2026-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "GA",
"license": "NP311059",
"primary": true
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "GA",
"license": "RN311059",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.