Active NPI
Eleanor Ludecke, CNP
- Obstetrics & Gynecology Nurse Practitioner
- Atlanta, GA
National Provider Identifier
1508921032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner
- License
- RN149205
- Practice address
- 980 Johnson Ferry Rd NE
Suite 620
Atlanta, GA 30342-1626 - Phone
- (404) 255-2057
- Fax
- (404) 256-4238
- NPI assigned
- Dec 26, 2006
- 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 |
|---|---|---|---|---|
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | RN149205 | GA | Primary |
Addresses
Primary practice location
980 Johnson Ferry Rd NE
Suite 620
Atlanta, GA 30342-1626
Mailing address
980 Johnson Ferry Rd NE
Suite 620
Atlanta, GA 30342-1626
Phone (404) 255-2057
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 750632085D | Medicaid | GA | |
| 750632085C | Medicaid | GA | |
| 750632085B | Medicaid | GA | |
| 750632085J | Medicaid | GA | |
| 750632085F | Medicaid | GA | |
| 750632085I | Medicaid | GA | |
| 750632085E | Medicaid | GA | |
| 750632085K | 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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289520000000",
"number": "1508921032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "980 JOHNSON FERRY RD NE",
"address_2": "SUITE 620",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303421626",
"telephone_number": "404-255-2057",
"fax_number": "404-256-4238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "980 JOHNSON FERRY RD NE",
"address_2": "SUITE 620",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303421626",
"telephone_number": "404-255-2057",
"fax_number": "404-256-4238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUDECKE",
"first_name": "ELEANOR",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-26",
"last_updated": "2010-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "GA",
"license": "RN149205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "750632085D",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "750632085C",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "750632085B",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "750632085J",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "750632085F",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "750632085I",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "750632085E",
"state": "GA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "750632085K",
"state": "GA"
}
],
"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 Nov 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.