Individual provider Active NPI

Philip Charles Yarri Jr., FNP-C

  • Nurse Practitioner
  • Newnan, GA
National Provider Identifier
1851075808
Registry record updated Jun 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F05231213 Issued in GA
Practice address
69 Woodlake Dr
Newnan, GA 30265-1971
Phone
(770) 846-8897
NPI assigned
Jun 12, 2023
Last updated
Jun 12, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F05231213 GA Primary

Addresses

Primary practice location

69 Woodlake Dr
Newnan, GA 30265-1971

Mailing address

69 Woodlake Dr
Newnan, GA 30265-1971
Phone (770) 846-8897

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
I20240122000178 GA Practitioner - Nurse Practitioner 8820440340 Reassigns benefits to 2 organizations

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
Sandy Creek Emergency Group, PCGroup PAC ID 3577905520, 44 clinicians

Practice addresses (Care Compare)

1255 Hwy 54 W
Fayetteville, GA 30214-4526
Phone (770) 719-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F05231213GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Em-I Medical Services, LLC Nurse Practitioner CurrentSince Dec 9, 2023 Accepting new patients
Sandy Creek Emergency Group, PC Nurse Practitioner CurrentSince Jul 1, 2024 Accepting new patients
Georgia Em-I Medical Services. LLC Nurse Practitioner Current Accepting new patients
Georgia Em-I Medical Services P C Nurse Practitioner CurrentSince Dec 9, 2023 Accepting new patients

Locations

5126 Hospital Dr NE
Covington, GA 30014
Phone (770) 385-4340

1255 Highway 54 W
Fayetteville, GA 30214
Phone (770) 719-6911

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1851075808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 WOODLAKE DR",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651971",
            "telephone_number": "770-846-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 WOODLAKE DR",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302651971",
            "telephone_number": "770-846-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YARRI",
        "first_name": "PHILIP",
        "middle_name": "CHARLES",
        "name_suffix": "Jr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-12",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "F05231213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

Verify at the official NPI Registry.