Individual provider Active NPI

Chandila Yvette Tutt, RN, CNS, FNP

  • Family Nurse Practitioner
  • Decatur, GA
National Provider Identifier
1578637864
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R116406 Issued in GA
Practice address
34 Sycamore Sta
Decatur, GA 30030-2764
Phone
(404) 276-9489
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 116406 GA
Critical Care Medicine Clinical Nurse Specialist 364SC0200X R116406 GA
Family Nurse Practitioner 363LF0000X R116406 GA Primary

Addresses

Primary practice location

34 Sycamore Sta
Decatur, GA 30030-2764

Mailing address

34 Sycamore Sta
Decatur, GA 30030-2764
Phone (404) 276-9489

Other practice location 1

1670 Clairmont Rd
Decatur, GA 30033-4004
Phone (404) 321-6111

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
Certified Nurse Specialist, Registered Nurse

State licenses

LicenseStateTypeSpecialty
116406GAMDCritical Care Medicine Registered Nurse
R116406GAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1578637864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 SYCAMORE STA",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302764",
            "telephone_number": "404-276-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 SYCAMORE STA",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302764",
            "telephone_number": "404-276-9489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1670 Clairmont Rd",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300334004",
            "country_code": "US",
            "telephone_number": "404-321-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUTT",
        "first_name": "CHANDILA",
        "middle_name": "YVETTE",
        "name_prefix": "Ms.",
        "credential": "RN, CNS, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "GA",
            "license": "116406",
            "primary": false
        },
        {
            "code": "364SC0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Critical Care Medicine",
            "state": "GA",
            "license": "R116406",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "R116406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.