Individual provider Active NPI

Karen Domitila Zavala-Abrego

  • Maternal Newborn Registered Nurse
  • Gainesville, GA
National Provider Identifier
1669272019
Registry record updated Jul 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal Newborn Registered NurseTaxonomy code 163WM0102X
License
300402 Issued in GA
Practice address
1315 Jesse Jewell Pkwy NE Ste 200
Gainesville, GA 30501-3821
Phone
(770) 219-9300
NPI assigned
Mar 14, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Maternal Newborn Registered Nurse 163WM0102X 300402 GA Primary

Addresses

Primary practice location

1315 Jesse Jewell Pkwy NE Ste 200
Gainesville, GA 30501-3821

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

1315 Jesse Jewell Pkwy NE Ste 201
Gainesville, GA 30501-3811
Phone (770) 219-9300

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250724002409 GA Practitioner - Certified Nurse Midwife (CNM) 8729595855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1315 Jesse Jewell Pkwy NE
Suite 110
Gainesville, GA 30501-3822
Phone (770) 219-0023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
300402GAMDMaternal Newborn Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc CurrentSince Jul 17, 2025 Accepting new patients

Locations

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

1315 Jesse Jewell Pkwy NE
Ste 200
Gainesville, GA 30501
Phone (770) 219-9300

1315 Jesse Jewell Pkwy NE
Ste 110
Gainesville, GA 30501
Phone (770) 219-0023

1315 Jesse Jewell Pkwy NE
Ste 201
Gainesville, GA 30501
Phone (770) 219-8765

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1741910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753056000000",
    "number": "1669272019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 JESSE JEWELL PKWY NE STE 200",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013821",
            "telephone_number": "770-219-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1315 Jesse Jewell Pkwy NE Ste 201",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "GA",
            "postal_code": "305013811",
            "country_code": "US",
            "telephone_number": "770-219-9300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAVALA-ABREGO",
        "first_name": "KAREN",
        "middle_name": "DOMITILA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-14",
        "last_updated": "2025-07-21",
        "certification_date": "2025-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "GA",
            "license": "300402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.