Chelsea Dawn Malinowski

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

12.007207 Issued in CT

Practice address

105 Carnegie PL Ste 103
Fayetteville, GA 30214-5900

Phone

(770) 716-7999

Fax

(770) 716-8444

NPI assigned

Sep 1, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA, NY2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

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.

• Southeast Medical Group, P.C.

  • Family Medicine Physician
  • Alpharetta, GA
  • NPI 1235296054
  Medicare reassignment NPD
• Physician First Health Network

  • Public Health or Welfare Agency
  • Alpharetta, GA
  • NPI 1598558181
  NPD (past)

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

{
    "created_epoch": "1504224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1659899375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 BRIDLEWOOD RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060742513",
            "telephone_number": "860-424-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CARNEGIE PL STE 103",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302145900",
            "telephone_number": "770-716-7999",
            "fax_number": "770-716-8444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26 Shenipsit Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Tolland",
            "state": "CT",
            "postal_code": "060842332",
            "country_code": "US",
            "telephone_number": "860-872-2999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALINOWSKI",
        "first_name": "CHELSEA",
        "middle_name": "DAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-01",
        "last_updated": "2024-05-10",
        "certification_date": "2024-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CT",
            "license": "12.007207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12.007207",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Madoni, LPC, NCC
• Thomas Mahr, PHARMD
• Brandon Maisel Ramos, D.O
• Pooja Maknoor
• Malaika Health Group LLC
• Muun Queen Malone, APRN, ACCNS-AG, FNP
• Sheena Powell Manders, PA-C
• Joan Mangarelli, RPH
• Michaela Manias
• Valarie Wright Manley, MD

• Gerontology Nurse Practitioner in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Gerontology Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.