Sara Boufakhreddine, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704395228 Issued in MI

Practice address

1520 Clifton Rd NE
Atlanta, GA 30322-4201

Phone

(404) 727-7980

NPI assigned

May 12, 2023

Last updated

May 12, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wellstar Medical Group, LLC

  dba WellStar Family Medicine ACW

  • Family Medicine Physician
  • Kennesaw, GA
  • NPI 1558664003
  Medicare reassignment NPD
• Wellstar Medical Group, LLC

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1275992240
  NPD
• Wellstar Medical Group, LLC

  dba WellStar SafePath Childrens Advocacy Center

  • Child Abuse Pediatrics Physician
  • Marietta, GA
  • NPI 1356736250
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1683849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1487344370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303224201",
            "telephone_number": "404-727-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 CLIFTON RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303224201",
            "telephone_number": "404-727-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUFAKHREDDINE",
        "first_name": "SARA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-12",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704395228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Boucher, BCBA
• Yazan Adam Bouchi
• Ghizlane Bouchrit, MD
• Elise Boudreaux, CAA
• Jeanne Boudreaux, MD
• Elizabeth Bouffanie
• Leah Bougere, PSY.D.
• Joyce A Bouknight Gant, REGISTERED NURSE
• Emerson Bouldin
• Briana Jewel Boulin

• Registered Nurse in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.

Verify at the official NPI Registry.