Individual provider Active NPI

Marlene Powell-Bryan, RN

  • Home Health Aide
  • Conyers, GA
National Provider Identifier
1649518093
Registry record updated Jan 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
122-R-1098 Issued in GA
Practice address
2552 Westchester Way SE
Conyers, GA 30013-6448
Phone
(770) 760-1597
NPI assigned
Jan 18, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X 122-R-1098 GA Primary

Addresses

Primary practice location

2552 Westchester Way SE
Conyers, GA 30013-6448

Mailing address

2552 Westchester Way SE
Conyers, GA 30013-6448
Phone (770) 760-1597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
122-R-1098GAMDHome Health Aide

Practice roles

OrganizationSpecialtyStatusNew patients
DDP Nursing Services of Ga. Inc Home Health Aide Past Accepting new patients

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": "1358467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358467200000",
    "number": "1649518093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2552 WESTCHESTER WAY SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136448",
            "telephone_number": "770-760-1597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2552 WESTCHESTER WAY SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136448",
            "telephone_number": "770-760-1597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL-BRYAN",
        "first_name": "MARLENE",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-18",
        "last_updated": "2013-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "GA",
            "license": "122-R-1098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.