Rena Loraine Castlin, NP
Individual provider Active NPI Family Nurse Practitioner · Marietta, GA
NPI 1619216892 · NPPES record last updated Sep 20, 2018
Key facts
- NPI
- 1619216892
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN153122 (GA)
- Practice address
- 400 Tower Rd NE
Suite 350
Marietta, GA 30060-9411 - Phone
- (770) 590-1078
- Fax
- (770) 422-7306
- NPI assigned
- Feb 7, 2013
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- McIntosh Trail Community Service Board
Practice addresses (Care Compare)
1209 Greenbelt Dr
Griffin, GA 30224-4507
Phone (770) 358-5252
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130514000690 | GA | Practitioner - Nurse Practitioner | 4082851829 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5010852 | NC | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clayton Center Mhaddd | Current |
Accepting new patients | |
| McIntosh Trail Community Service Board | Current |
Accepting new patients | |
| Upson County Hospital Inc | Current |
Accepting new patients | |
| McIntosh Trail Community Service Board | Current |
Accepting new patients | |
| Upson County Hospital Inc | Current |
Accepting new patients | |
| Clayton Community Mental Health Substance Abuse Deve SVCS Board | Current | Accepting new patients | |
| Advanced Recovery Systems, LLC | Past | Accepting new patients | |
| Advanced Recovery Systems, LLC | Past | Accepting new patients | |
| Clayton Center CSB | Past | Accepting new patients | |
| Pain Solutions Treatment Centers | Past | Accepting new patients |
Locations
1435 N Expressway
Ste 301
Griffin, GA 30223
Phone (678) 516-5179
1209 Greenbelt Dr
Griffin, GA 30224
Phone (770) 358-8258
853 Battlecreek Rd
Jonesboro, GA 30236
Phone (770) 478-1099
157 Smith St
Jonesboro, GA 30236
Phone (770) 473-2464
1792 Mount Zion Rd
Morrow, GA 30260
Phone (770) 960-2009
801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 5010852 | NC | |
| Family Nurse Practitioner | 363LF0000X | RN153122 | GA | Yes |
Addresses
Primary practice location
400 Tower Rd NE
Suite 350
Marietta, GA 30060-9411
Mailing address
400 Tower Rd NE
Suite 350
Marietta, GA 30060-9411
Phone (770) 590-1078
Other practice location 1
311 Judges Rd Ste 4E
Wilmington, NC 28405-3655
Phone (910) 791-6767
Other providers in Marietta, GA
- Cassandra Cammon
- Michelle Cast
- Christine Aisha Castater
- Castiblanco Dental Care LLC
- Adriana Castiblanco
- Kimberly Castoe
- Victor Castresana
- Isabela Castro Sucre
- Ashlee Elaina Castro-Scott
- Daniela Castro
All providers in Marietta, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.