Active NPI
Mona Izadi, FNP-BC
- Family Nurse Practitioner
- Blue Ridge, GA
National Provider Identifier
1568700334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- RN079353
- Practice address
- 10152 Blue Ridge Dr
Blue Ridge, GA 30513-5935 - Phone
- (706) 946-3621
- Fax
- (706) 946-3622
- NPI assigned
- Jan 29, 2013
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN079353 | GA | Primary |
Addresses
Primary practice location
10152 Blue Ridge Dr
Blue Ridge, GA 30513-5935
Mailing address
10152 Blue Ridge Dr
Blue Ridge, GA 30513-5935
Phone (706) 946-3621
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)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Marc S. Berger, M.D., P.a. | Family | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429574400000",
"number": "1568700334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10152 BLUE RIDGE DR",
"city": "BLUE RIDGE",
"state": "GA",
"postal_code": "305135935",
"telephone_number": "706-946-3621",
"fax_number": "706-946-3622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10152 BLUE RIDGE DR",
"city": "BLUE RIDGE",
"state": "GA",
"postal_code": "305135935",
"telephone_number": "706-946-3621",
"fax_number": "706-946-3622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IZADI",
"first_name": "MONA",
"name_prefix": "Mrs.",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-29",
"last_updated": "2015-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RN079353",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Ridge, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.