Individual provider Active NPI

Vanessa Rosales West, APRN

  • Family Nurse Practitioner
  • Woodstock, GA
National Provider Identifier
1831878974
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN288956 Issued in GA
Practice address
310 Gold Creek TRL Ste 200
Woodstock, GA 30188-5436
Phone
(770) 927-7857
NPI assigned
Jul 17, 2023
Last updated
Jul 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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 RN288956 GA Primary

Addresses

Primary practice location

310 Gold Creek TRL Ste 200
Woodstock, GA 30188-5436

Mailing address

209 Ridgeview CT
Canton, GA 30114-7009
Phone (706) 273-8099

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
I20230825002317 GA Practitioner - Nurse Practitioner 6002279866 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Medical Group, P.C. CurrentSince Aug 1, 2023 Accepting new patients

Locations

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

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

250 Parkbrooke Pl
Ste 300
Woodstock, GA 30189
Phone (770) 870-1780

310 Gold Creek Trl
Ste 200
Woodstock, GA 30188
Phone (770) 771-5600

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DIJIBA

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": "1689552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689552000000",
    "number": "1831878974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 RIDGEVIEW CT",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301147009",
            "telephone_number": "706-273-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 GOLD CREEK TRL STE 200",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301885436",
            "telephone_number": "770-927-7857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEST",
        "first_name": "VANESSA",
        "middle_name": "ROSALES",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN288956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

Verify at the official NPI Registry.