Individual provider Active NPI

Rose Gayle-Smith, N.P.

  • Nurse Practitioner
  • Conyers, GA
National Provider Identifier
1679962534
Registry record updated Jan 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN092585 Issued in GA
Practice address
2081 Millstone Dr SW
Conyers, GA 30094-3981
Phone
(404) 272-4405
NPI assigned
Jan 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN092585 GA Primary

Addresses

Primary practice location

2081 Millstone Dr SW
Conyers, GA 30094-3981

Mailing address

2081 Millstone Dr SW
Conyers, GA 30094-3981
Phone (404) 272-4405

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
I20210205002106 GA Practitioner - Nurse Practitioner 5597046037 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN092585GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Post Acute Care Leaders LLC Nurse Practitioner CurrentSince Jan 1, 2021 Accepting new patients
Vitas Healthcare Corporation of Georgia CurrentSince May 1, 2022 Accepting new patients

Locations

925 North Point Pkwy
Ste 425
Alpharetta, GA 30005
Phone (678) 593-3332

156 Pine Knoll Dr
Carrollton, GA 30117
Phone (770) 832-8243

2000 Riveredge Pkwy
Ste GL100
Sandy Springs, GA 30328
Phone (404) 843-6500

Organizations & group practices 2

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": "1421280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1679962534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2081 MILLSTONE DR SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300943981",
            "telephone_number": "404-272-4405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2081 MILLSTONE DR SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300943981",
            "telephone_number": "404-272-4405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYLE-SMITH",
        "first_name": "ROSE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-15",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN092585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.