Individual provider Active NPI

Sifiso Rodger, NP

  • Nurse Practitioner
  • Austell, GA
National Provider Identifier
1477812782
Registry record updated May 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN192030 Issued in GA
Practice address
3950 Austell Rd
Austell, GA 30106-1121
Phone
(770) 732-5570
NPI assigned
May 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN192030 GA Primary

Addresses

Primary practice location

3950 Austell Rd
Austell, GA 30106-1121

Mailing address

5665 New Northside Dr NW
Suite 320
Atlanta, GA 30328-5831
Phone (770) 874-5468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NC2 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
I20120612000626 GA Practitioner - Nurse Practitioner 4284898727 Reassigns benefits to 2 organizations
I20171120001362 NC Practitioner - Nurse Practitioner 4284898727 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN192030GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
FHPG, LLC CurrentSince Oct 9, 2017 Accepting new patients
The Bortolazzo Group, LLC CurrentSince May 1, 2012 Accepting new patients
Piedmont Healthcare Inc CurrentSince May 5, 2014 Accepting new patients
FHPG, LLC CurrentSince Oct 9, 2017 Accepting new patients
FHPG, LLC Current Accepting new patients

Locations

1984 Peachtree Rd NW
Ste 205
Atlanta, GA 30309

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

5665 New Northside Dr
Ste 320
Sandy Springs, GA 30328
Phone (770) 874-5468

46 Memorial Dr
Pinehurst, NC 28374
Phone (910) 295-6782

155 Memorial Dr
Pinehurst, NC 28374
Phone (910) 215-1000

6408 Fayetteville Rd
Raeford, NC 28376
Phone (910) 878-6000

925 S Long Dr
Rockingham, NC 28379
Phone (910) 417-3000

520 Allen St
Troy, NC 27371
Phone (910) 571-5000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • Direct secure messaging: sifiso.rodger.1@1215.direct.athenahealth.com

Organizations & group practices 6

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": "1336348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336348800000",
    "number": "1477812782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5665 NEW NORTHSIDE DR NW",
            "address_2": "SUITE 320",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285831",
            "telephone_number": "770-874-5468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 AUSTELL RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061121",
            "telephone_number": "770-732-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODGER",
        "first_name": "SIFISO",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-07",
        "last_updated": "2012-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN192030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.