Individual provider Active NPI

Katherine Maria Chavarria

  • Acute Care Nurse Practitioner
  • Cumming, GA
National Provider Identifier
1841059862
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
RN279134 Issued in GA
Practice address
1200 Northside Forsyth Dr Ste 240a
Cumming, GA 30041-7659
Phone
(770) 844-3200
NPI assigned
Mar 14, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X RN279134 GA Primary

Addresses

Primary practice location

1200 Northside Forsyth Dr Ste 240a
Cumming, GA 30041-7659

Mailing address

1200 Northside Forsyth Dr Ste 240a
Cumming, GA 30041-7659

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
I20240409003917 GA Practitioner - Nurse Practitioner 7315385333 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Atlanta Professional Services LLCGroup PAC ID 0840291944, 423 clinicians

Practice addresses (Care Compare)

1000 Johnson Ferry Rd NE
Atlanta, GA 30342-1606
Phone (404) 851-8000

Hospital & facility affiliations

  • Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
  • Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN279134GAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Atlanta Professional Services LLC CurrentSince Jun 1, 2024 Accepting new patients

Locations

1200 Northside Forsyth Dr
Ste 240A
Cumming, GA 30041

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1710374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1841059862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 NORTHSIDE FORSYTH DR STE 240A",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NORTHSIDE FORSYTH DR STE 240A",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300417659",
            "telephone_number": "770-844-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAVARRIA",
        "first_name": "KATHERINE",
        "middle_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-14",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN279134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.