Active NPI
Nyla Faye Cline, NURSE PRACTIONER
- Pediatric Adolescent Medicine Physician
- Carrollton, GA
National Provider Identifier
1497738777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- RN065545 NP
- Practice address
- 804 Dixie St
Carrollton, GA 30117-4416 - Phone
- (770) 834-0606
- Fax
- (770) 834-1833
- NPI assigned
- Nov 21, 2005
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | RN065545 NP | GA | Primary |
Addresses
Primary practice location
804 Dixie St
Carrollton, GA 30117-4416
Mailing address
804 Dixie St
Carrollton, GA 30117-4416
Phone (770) 834-0606
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00803448A | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN065545 NP | GA | MD | Pediatric Adolescent Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325808000000",
"number": "1497738777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 DIXIE ST",
"city": "CARROLLTON",
"state": "GA",
"postal_code": "301174416",
"telephone_number": "770-834-0606",
"fax_number": "770-834-1833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 DIXIE ST",
"city": "CARROLLTON",
"state": "GA",
"postal_code": "301174416",
"telephone_number": "770-834-0606",
"fax_number": "770-834-1833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLINE",
"first_name": "NYLA",
"middle_name": "FAYE",
"credential": "NURSE PRACTIONER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-21",
"last_updated": "2012-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "GA",
"license": "RN065545 NP",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00803448A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carrollton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.