Individual provider Active NPI

Khamariah Patrice Yelder-Anderson

  • Family Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1568270635
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP324120 Issued in GA
Practice address
1100 Johnson Ferry Rd Ste 510
Marietta, GA 30068-2794
Phone
(943) 888-9006
NPI assigned
Dec 20, 2024
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN-NP324120 GA Primary
Registered Nurse 163W00000X RN324120 GA

Addresses

Primary practice location

1100 Johnson Ferry Rd Ste 510
Marietta, GA 30068-2794

Mailing address

590 Lanier Ave W
Fayetteville, GA 30214-1504
Phone (678) 688-9685

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

LicenseStateTypeSpecialty
RN324120GAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1734652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1568270635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 LANIER AVE W",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141504",
            "telephone_number": "678-688-9685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 JOHNSON FERRY RD STE 510",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682794",
            "telephone_number": "943-888-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YELDER-ANDERSON",
        "first_name": "KHAMARIAH",
        "middle_name": "PATRICE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-20",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP324120",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN324120",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; 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.