Individual provider Active NPI

Ebony Noel Barnes, LPN

  • Licensed Practical Nurse
  • Stone Mountain, GA
National Provider Identifier
1770170052
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN095133 Issued in GA
Practice address
718 Post Road LN
Stone Mountain, GA 30088-2246
Phone
(601) 517-7078
NPI assigned
Dec 21, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193400000X SINGLE SPECIALTY GROUP 164W00000X LPN095133 GA Primary

Addresses

Primary practice location

718 Post Road LN
Stone Mountain, GA 30088-2246

Mailing address

718 Post Road LN
Stone Mountain, GA 30088-2246
Phone (601) 517-7078

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
LPN095133GAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1608508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1770170052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 POST ROAD LN",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300882246",
            "telephone_number": "601-517-7078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "718 POST ROAD LN",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300882246",
            "telephone_number": "601-517-7078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "EBONY",
        "middle_name": "NOEL",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-21",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "LPN095133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; 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.