Individual provider Active NPI

Chandra Torry, APRN

  • Family Nurse Practitioner
  • Dallas, GA
National Provider Identifier
1770949364
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
232566 Issued in GA
Practice address
495 Charles Hardy Pkwy
Dallas, GA 30157-5723
Phone
(770) 445-2128
Fax
(770) 505-4470
NPI assigned
Jan 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 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 232566 GA Primary

Addresses

Primary practice location

495 Charles Hardy Pkwy
Dallas, GA 30157-5723

Mailing address

495 Charles Hardy Pkwy
Dallas, GA 30157-5723
Phone (770) 445-2128

Other practice location 1

11990 Jackson St
Clinton, LA 70722-3210
Phone (225) 683-5292

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Permanente Medical Group

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
I20180611002605 GA Practitioner - Nurse Practitioner 7719282987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

5440 Hillandale Dr
Lithonia, GA 30058-4865
Phone (770) 322-3238

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
232566GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group CurrentSince Jun 4, 2018 Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

1478 Dogwood Dr SE
Ste C
Conyers, GA 30013
Phone (678) 413-4320

5440 Hillandale Dr
Lithonia, GA 30058
Phone (770) 322-2716

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, 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": "1452556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1770949364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 CHARLES HARDY PKWY",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301575723",
            "telephone_number": "770-445-2128",
            "fax_number": "770-505-4470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 CHARLES HARDY PKWY",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301575723",
            "telephone_number": "770-445-2128",
            "fax_number": "770-505-4470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11990 Jackson St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "LA",
            "postal_code": "707223210",
            "country_code": "US",
            "telephone_number": "225-683-5292",
            "fax_number": "225-683-3411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TORRY",
        "first_name": "CHANDRA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-12",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "232566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5440 Hillandale Dr",
            "city": "Lithonia",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300584865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

Verify at the official NPI Registry.