Active NPI
Nurse Practioner
- Community Health Clinic/Center
- Kennesaw, GA
National Provider Identifier
1629519202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Clinic/Center
- License
- 193760
- Legal business name
- NURSE PRACTIONER
- Practice address
- 4044 George Busbee Pkwy NW Apt 4207
Kennesaw, GA 30144-6890 - Phone
- (404) 579-1658
- NPI assigned
- Mar 15, 2017
- Organization subpart
- Yes
- Parent organization
- INDEPENDENT CONTRACTOR
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rose Kombe, NP
- Title
- FNP
- Phone
- (404) 579-1658
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | 193760 | GA | Primary |
| Point of Service | 305S00000X | 193760 | GA |
Addresses
Primary practice location
4044 George Busbee Pkwy NW Apt 4207
Kennesaw, GA 30144-6890
Mailing address
PO Box 1234
Powder Springs, GA 30127-7234
Phone (404) 579-1658
National Provider Directory
National Provider Directory- Part of
- Cherry'S Family Care Home 2
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489536000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1489536000000",
"number": "1629519202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1234",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301277234",
"telephone_number": "404-579-1658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4044 GEORGE BUSBEE PKWY NW APT 4207",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301446890",
"telephone_number": "404-579-1658"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NURSE PRACTIONER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "INDEPENDENT CONTRACTOR",
"enumeration_date": "2017-03-15",
"last_updated": "2017-03-15",
"status": "A",
"authorized_official_last_name": "KOMBE",
"authorized_official_first_name": "ROSE",
"authorized_official_title_or_position": "FNP",
"authorized_official_telephone_number": "404-579-1658",
"authorized_official_credential": "NP"
},
"taxonomies": [
{
"code": "261QC1500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Community Health",
"state": "GA",
"license": "193760",
"primary": true
},
{
"code": "305S00000X",
"taxonomy_group": "",
"desc": "Point of Service",
"state": "GA",
"license": "193760",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.