Phyllis Burr Dove-Edwin

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

RN152509 Issued in GA

Practice address

1818 Lakefield CT SE Ste B
Conyers, GA 30013-6610

Phone

(404) 784-9158

Fax

(404) 203-2421

NPI assigned

Jan 21, 2015

Last updated

Aug 9, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Innovative Nursing Solutions and Hospice Care LLC

  dba INS Hospice

  • Community Based Hospice Care Agency
  • Conyers, GA
  • NPI 1598203358
  NPD Authorized official
• Innovative Nursing Solutions of Georgia LLC

  dba Innovative Nursing Soultions

  • In Home Supportive Care Agency
  • Conyers, GA
  • NPI 1518593946
  NPD Authorized official

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1548659071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 LAKEFIELD CT SE STE B",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136610",
            "telephone_number": "404-784-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1818 LAKEFIELD CT SE STE B",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136610",
            "telephone_number": "404-784-9158",
            "fax_number": "404-203-2421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOVE-EDWIN",
        "first_name": "PHYLLIS",
        "middle_name": "BURR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-21",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "GA",
            "license": "RN152509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tyneisha Donisha Douglas, CLINICAL SOCIAL WORK
• Deirdre Dolan Douglass, P.T.
• Jamyah Douglass
• Jessica Ming-Chu Doyle, MD
• Dr Transport LLC
• Deanna Drayton, RBT
• Dream 4 You Coaching and Counseling Services
• Drips in Motion Infusion Bar LLC

• Case Management Registered Nurse in Conyers, GA
• Providers in Conyers, GA by specialty
• Case Management Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.