Charlotte David, FNP, BSN, RN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN215851 Issued in GA

Practice address

704 Breedlove Dr Ste a
Monroe, GA 30655-2054

Phone

(888) 772-0076

Fax

(770) 751-8014

NPI assigned

Dec 26, 2018

Sex

Female

Sole proprietor

No

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

Practice roles

Locations

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.

• Chronic Disease Management of Georgia, LLC

  • Physical Medicine & Rehabilitation Physician
  • Monroe, GA
  • NPI 1699300939
  Medicare reassignment NPD
• Georgia Mso LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1952196164
  Medicare reassignment NPD
• Hardy Renew Wellness,LLC

  • Internal Medicine Physician
  • Marietta, GA
  • NPI 1952914368
  Medicare reassignment NPD
• Transitional Care Physicians of Georgia PC

  • Specialist
  • Monroe, GA
  • NPI 1619317542
  Medicare reassignment NPD

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

{
    "created_epoch": "1545782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545782400000",
    "number": "1700358140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5856",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311070856",
            "telephone_number": "888-772-0076",
            "fax_number": "770-751-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 BREEDLOVE DR STE A",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306552054",
            "telephone_number": "888-772-0076",
            "fax_number": "770-751-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVID",
        "first_name": "CHARLOTTE",
        "credential": "FNP, BSN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-26",
        "last_updated": "2018-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN215851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "RN215851",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grant David Crawfod
• Creative Center for Wellness, Incorporated
• Melody Faye Cuevas, LMSW
• Daniel a Hodges
• Rebecca Joan Daniel, AGACNP
• Del Mar Medical Supply LLC
• Cesar Medalla Delima, M.D.
• Judith D Delima, M.D.
• William Donovan Delp, D.O.
• Destiney Dempsey, LMSW

• Family Nurse Practitioner in Monroe, GA
• Providers in Monroe, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2018; 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.