Individual provider Active NPI

Rebecca Elaine Boatner, FNP

  • Nurse Practitioner
  • Nashville, GA
National Provider Identifier
1720941503
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN321770 Issued in GA
Practice address
107 S Davis St
Nashville, GA 31639-2113
Phone
(229) 638-6726
Fax
(229) 518-4425
NPI assigned
Dec 8, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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 RN321770 GA Primary

Addresses

Primary practice location

107 S Davis St
Nashville, GA 31639-2113

Mailing address

205 George Roland LN
Adel, GA 31620-9258
Phone (229) 638-6726

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

State licenses

LicenseStateTypeSpecialty
RN321770GAMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1765152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1720941503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 GEORGE ROLAND LN",
            "city": "ADEL",
            "state": "GA",
            "postal_code": "316209258",
            "telephone_number": "229-638-6726",
            "fax_number": "229-518-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S DAVIS ST",
            "city": "NASHVILLE",
            "state": "GA",
            "postal_code": "316392113",
            "telephone_number": "229-638-6726",
            "fax_number": "229-518-4425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATNER",
        "first_name": "REBECCA",
        "middle_name": "ELAINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-08",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN321770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.