Dorene Ebangha Etarock, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN296118 Issued in GA

Practice address

8111 Ball Ground Hwy
Ball Ground, GA 30107

Phone

(770) 268-4011

NPI assigned

Jun 6, 2018

Last updated

Aug 13, 2024By 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: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aylo Health, LLCGroup PAC ID 8022901925, 112 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as group

Quality

0

Promoting interoperability

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dorene.etarock@elfp.eclinicaldirectplus.com

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.

• Aylo Health, LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1013018811
  Medicare reassignment Care Compare group NPD
• Applebaum Physiatry PLLC

  • Physical Medicine & Rehabilitation Physician
  • Oak Brook, IL
  • NPI 1700598059

  Family, GA

  Medicare reassignment NPD
• Aylo Health, LLC

  • Diagnostic Radiology Physician
  • Locust Grove, GA
  • NPI 1194433219
  NPD
• Aylo Health, LLC

  • Family Medicine Physician
  • Ellenwood, GA
  • NPI 1447290218
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Locust Grove, GA
  • NPI 1710929914
  NPD (past)
• Aylo Health, LLC

  • Sleep Medicine (Family Medicine) Physician
  • Stockbridge, GA
  • NPI 1922831445
  NPD (past)
• Felicia Ochei MD PLLC

  dba PM Pediatrics

  • Pediatrics Physician
  • Lewisville, TX
  • NPI 1487835484
  NPD (past)
• Nursing Home Physician Group PLLC

  • Physical Medicine & Rehabilitation Physician
  • Warrenville, IL
  • NPI 1417703844
  NPD (past)

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723507200000",
    "number": "1518450352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 RIVERWOOD PKWY SE STE 250",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393304",
            "telephone_number": "770-914-0116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 BALL GROUND HWY",
            "city": "BALL GROUND",
            "state": "GA",
            "postal_code": "30107",
            "telephone_number": "770-268-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETAROCK",
        "first_name": "DORENE",
        "middle_name": "EBANGHA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-06",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN296118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Circle of Friends: Celebrating Life, Inc
• Shelby Louise Clarke
• Dodd Surgical Assisiting
• Dodd Surgical Assisting, LLC
• David D Dodd, OPA-C, CSA
• Naquana Fields
• Aaron Fuchs, CCC-SLP
• Maria Gagnon, OTR/L
• Gray's Purpose LLC
• Heather Hardy, IBCLC, RLC

• Family Nurse Practitioner in Ball Ground, GA
• Providers in Ball Ground, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.