Individual provider Active NPI

Valerie Modupeh Cole, FNP-C

  • Family Nurse Practitioner
  • Dacula, GA
National Provider Identifier
1770822397
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN145608 Issued in GA
Practice address
505 Dacula Rd
Dacula, GA 30019-2125
Phone
(678) 407-8750
NPI assigned
Feb 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 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 RN145608 GA Primary

Addresses

Primary practice location

505 Dacula Rd
Dacula, GA 30019-2125

Mailing address

426 Jasmine Dr
Winder, GA 30680-8510
Phone (404) 775-5133

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
I20130521000048 GA Practitioner - Nurse Practitioner 8325286925

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2620 Elm Hill Pike
Nashville, TN 37214-3108

426 Jasmine Dr
Winder, GA 30680-8510

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN145608GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TLC of Georgia LLC Family CurrentSince Apr 22, 2013 Accepting new patients

Locations

505 Dacula Rd
Dacula, GA 30019
Phone (678) 407-8740

455 Nathan Dean Blvd
Dallas, GA 30132
Phone (770) 443-8776

3600 Dallas Hwy SW
Marietta, GA 30064
Phone (770) 420-9170

2620 Elm Hill Pike
Nashville, TN 37214
Phone (615) 425-4211

Interoperability endpoints

  • Direct secure messaging: valerie.cole@krogerhealth.eclinicaldirectplus.com

Organizations & group practices 1

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": "1359676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1770822397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "426 JASMINE DR",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306808510",
            "telephone_number": "404-775-5133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 DACULA RD",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300192125",
            "telephone_number": "678-407-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "VALERIE",
        "middle_name": "MODUPEH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-01",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN145608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

Verify at the official NPI Registry.