Individual provider Active NPI

Rima Nitinchandra Vaidya, FNP

  • Family Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1477327815
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN279904 Issued in GA
Practice address
2536 Lawrenceville Hwy
Decatur, GA 30033-3227
Phone
(470) 452-4948
NPI assigned
Nov 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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 RN279904 GA Primary

Addresses

Primary practice location

2536 Lawrenceville Hwy
Decatur, GA 30033-3227

Mailing address

5400 Lakebrooke Run
Stone Mountain, GA 30087-3497
Phone (678) 697-3284

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240416002591 GA Practitioner - Family Practice 8921447566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
First Medical Care IncGroup PAC ID 6204821655, 4 clinicians

Practice addresses (Care Compare)

2536 Lawrenceville Hwy
Decatur, GA 30033-3227
Phone (470) 452-4948

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN279904GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
First Medical Care Inc CurrentSince Feb 8, 2024 Accepting new patients

Locations

2536 Lawrenceville Hwy
Decatur, GA 30033
Phone (404) 501-7444

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": "1699315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1477327815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 LAKEBROOKE RUN",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873497",
            "telephone_number": "678-697-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2536 LAWRENCEVILLE HWY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333227",
            "telephone_number": "470-452-4948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAIDYA",
        "first_name": "RIMA",
        "middle_name": "NITINCHANDRA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN279904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.