Individual provider Active NPI

Linda Vanosdol, NP

  • Family Nurse Practitioner
  • Warner Robins, GA
National Provider Identifier
1760922355
Registry record updated Mar 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN175366 Issued in GA
Practice address
1719 Russell Pkwy
Suite 700
Warner Robins, GA 31088-5763
Phone
(478) 328-7674
Fax
(478) 328-0807
NPI assigned
Mar 1, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2017

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 RN175366 GA Primary

Addresses

Primary practice location

1719 Russell Pkwy
Suite 700
Warner Robins, GA 31088-5763

Mailing address

1719 Russell Pkwy
Suite 700
Warner Robins, GA 31088-5763
Phone (478) 328-7674

Other identifiers 1

IdentifierTypeStateIssuer
RN175366OtherGAGEORGIA NURSE PRACTITIONER LICENSE NUMBER

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
I20170824000818 GA Practitioner - Nurse Practitioner 1557633625 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN175366GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Group, P.C. CurrentSince Nov 14, 2022 Accepting new patients
Houston County Emergency Group, LLC CurrentSince Jan 15, 2020 Accepting new patients
Houston County Emergency Group, LLC CurrentSince Jan 15, 2020 Accepting new patients

Locations

1255 Friendship Rd
Ste 130
Braselton, GA 30517
Phone (678) 341-6350

701 N Camellia Blvd
Fort Valley, GA 31030
Phone (478) 825-0023

4300 Northpoint Pkwy
Ste 300
Johns Creek, GA 30022
Phone (770) 518-4406

1601 Watson Blvd
Warner Robins, GA 31093
Phone (478) 322-5155

1719 Russell Pkwy
Ste 700
Warner Robins, GA 31088
Phone (478) 328-0806

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4
  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

Organizations & group practices 3

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": "1488326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488499200000",
    "number": "1760922355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 RUSSELL PKWY",
            "address_2": "SUITE 700",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310885763",
            "telephone_number": "478-328-7674",
            "fax_number": "478-328-0807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 RUSSELL PKWY",
            "address_2": "SUITE 700",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310885763",
            "telephone_number": "478-328-7674",
            "fax_number": "478-328-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANOSDOL",
        "first_name": "LINDA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN175366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA NURSE PRACTITIONER LICENSE NUMBER",
            "identifier": "RN175366",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

Verify at the official NPI Registry.