Individual provider Active NPI

Adrienne Botos Clark, MSN, BSN, RN, FNP-C

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1609683705
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN191508 Issued in GA
Practice address
1545 Rainier Falls Dr NE
Atlanta, GA 30329-4105
Phone
(404) 719-6746
NPI assigned
Dec 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN191508 GA Primary

Addresses

Primary practice location

1545 Rainier Falls Dr NE
Atlanta, GA 30329-4105

Mailing address

1545 Rainier Falls Dr NE
Atlanta, GA 30329-4105
Phone (404) 719-6746

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251217002310 GA Practitioner - Nurse Practitioner 7517452519 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Vanderbilt University School of Medicine, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Bortolazzo Group, LLCGroup PAC ID 3476554320, 98 clinicians

Practice addresses (Care Compare)

3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor on Science - Nursing, Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN191508GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Bortolazzo Group, LLC CurrentSince Nov 24, 2025 Accepting new patients
Qualified Quacks Registered Nurse CurrentSince Dec 15, 2024 Accepting new patients

Locations

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/25106/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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": "1733961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1609683705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1545 RAINIER FALLS DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303294105",
            "telephone_number": "404-719-6746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1545 RAINIER FALLS DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303294105",
            "telephone_number": "404-719-6746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ADRIENNE",
        "middle_name": "BOTOS",
        "credential": "MSN, BSN, RN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-12",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN191508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.