Individual provider Active NPI

Erin Dever, NP-C

  • Nurse Practitioner
  • Roswell, GA
National Provider Identifier
1619462553
Registry record updated Jun 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN215877 Issued in GA
Practice address
1475 Holcomb Bridge Rd
Roswell, GA 30076-2139
Phone
(678) 325-2250
NPI assigned
Jun 23, 2018
Last updated
Jun 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN215877 GA Primary
Family Nurse Practitioner 363LF0000X RN215877 GA

Addresses

Primary practice location

1475 Holcomb Bridge Rd
Roswell, GA 30076-2139

Mailing address

1475 Holcomb Bridge Rd
Roswell, GA 30076-2139
Phone (678) 325-2250

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
I20220520001271 GA Practitioner - Nurse Practitioner 2769869361

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Endocrine & Diabetes, P.C. CurrentSince Apr 1, 2022 Accepting new patients

Locations

1475 Holcomb Bridge Rd
Ste 129
Roswell, GA 30076
Phone (678) 325-2250

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1529712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1619462553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 HOLCOMB BRIDGE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300762139",
            "telephone_number": "678-325-2250",
            "fax_number": "678-325-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 HOLCOMB BRIDGE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300762139",
            "telephone_number": "678-325-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVER",
        "first_name": "ERIN",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-23",
        "last_updated": "2022-06-07",
        "certification_date": "2022-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN215877",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN215877",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.