Individual provider Active NPI

Anastasiya Fadyeyeva

  • Student in an Organized Health Care Education/Training Program
  • Griffin, GA
National Provider Identifier
1588466718
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
747 S 8TH St Ste B
Griffin, GA 30224-4884
Phone
(470) 604-8255
Fax
(770) 999-2814
NPI assigned
Mar 26, 2025
Last updated
Mar 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

747 S 8TH St Ste B
Griffin, GA 30224-4884

Mailing address

601 S 8TH St
Griffin, GA 30224-4213

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250729004575 GA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 0446767867

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1742947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1588466718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S 8TH ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 S 8TH ST STE B",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244884",
            "telephone_number": "470-604-8255",
            "fax_number": "770-999-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FADYEYEVA",
        "first_name": "ANASTASIYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-26",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffin, GA

Sources for this page

Verify at the official NPI Registry.