Individual provider Active NPI

Gloria Denise Cordero, FNP-C

  • Family Nurse Practitioner
  • Chamblee, GA
National Provider Identifier
1730623430
Registry record updated Jun 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN219975 Issued in GA
Practice address
5764 Peachtree Industrial Blvd
Chamblee, GA 30341-1908
Phone
(866) 389-2727
NPI assigned
Dec 14, 2016
Last updated
Jun 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN219975 GA Primary

Addresses

Primary practice location

5764 Peachtree Industrial Blvd
Chamblee, GA 30341-1908

Mailing address

5764 Peachtree Industrial Blvd
Chamblee, GA 30341-1908

Other practice location 1

6732 Story Cir
Norcross, GA 30093-3712
Phone (850) 252-0364

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
I20250724003431 GA Practitioner - Nurse Practitioner 6901313063 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Primary Care PLLCGroup PAC ID 0941642169, 19 clinicians
Minuteclinic LLCGroup PAC ID 6709850241, 576 clinicians

Practice addresses (Care Compare)

5764 Peachtree Industrial Blvd
Chamblee, GA 30341-1908
Phone (866) 389-2727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince Jul 8, 2025 Accepting new patients
Primary Care PLLC Family CurrentSince Jul 8, 2025 Accepting new patients
Musharaf Momin Inc Past Accepting new patients
McDonough Adult & Pediatric Medical Care Past Accepting new patients

Locations

5764 Peachtree Industrial Blvd
Chamblee, GA 30341
Phone (770) 457-4401

11710 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 754-0141

7207 Rockbridge Rd
Stone Mtn, GA 30087
Phone (770) 469-2002

1 Cvs Dr
#2295
Woonsocket, RI 02895
Phone (401) 770-8043

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1730623430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5764 PEACHTREE INDUSTRIAL BLVD",
            "city": "CHAMBLEE",
            "state": "GA",
            "postal_code": "303411908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5764 PEACHTREE INDUSTRIAL BLVD",
            "city": "CHAMBLEE",
            "state": "GA",
            "postal_code": "303411908",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6732 Story Cir",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300933712",
            "country_code": "US",
            "telephone_number": "850-252-0364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORDERO",
        "first_name": "GLORIA",
        "middle_name": "DENISE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-14",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN219975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chamblee, GA

Sources for this page

Verify at the official NPI Registry.