Individual provider Active NPI

Anna Roche, CPNP

  • Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1871144873
Registry record updated Jun 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN269670 Issued in GA
Practice address
5461 Meridian Mark Rd Ste 320
Atlanta, GA 30342-4014
Phone
(404) 785-3240
Fax
(404) 785-3600
NPI assigned
Sep 23, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2022

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 RN269670 GA Primary

Addresses

Primary practice location

5461 Meridian Mark Rd Ste 320
Atlanta, GA 30342-4014

Mailing address

5461 Meridian Mark Rd Ste 320
Atlanta, GA 30342-4014
Phone (404) 785-3240

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address choa@choa.gadirect.net

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
I20200124000382 GA Order and Referring Only - Nurse Practitioner 9931534773

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN269670GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Choa Hospital Based, LLC Past Accepting new patients
Egleston Pediatric Group Past Accepting new patients

Organizations & group practices 2

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": "1569196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654473600000",
    "number": "1871144873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5461 MERIDIAN MARK RD STE 320",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424014",
            "telephone_number": "404-785-3240",
            "fax_number": "404-785-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5461 MERIDIAN MARK RD STE 320",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303424014",
            "telephone_number": "404-785-3240",
            "fax_number": "404-785-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCHE",
        "first_name": "ANNA",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-23",
        "last_updated": "2022-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN269670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "choa@choa.gadirect.net",
            "affiliation": "N",
            "address_1": "5461 Meridian Mark Rd Ste 320",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303424014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.