Individual provider Active NPI

Cherley Edouazin, RN

  • Registered Nurse
  • Powder Springs, GA
National Provider Identifier
1871204214
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN187941 Issued in GA
Practice address
5322 Autumn Breeze LN
Powder Springs, GA 30127-5524
Phone
(678) 642-5743
NPI assigned
Dec 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN187941 GA Primary

Addresses

Primary practice location

5322 Autumn Breeze LN
Powder Springs, GA 30127-5524

Mailing address

5322 Autumn Breeze LN
Powder Springs, GA 30127-5524
Phone (678) 642-5743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN187941GAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Omega Homecare LLC CurrentSince Feb 8, 2023 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1871204214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5322 AUTUMN BREEZE LN",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301275524",
            "telephone_number": "678-642-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5322 AUTUMN BREEZE LN",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301275524",
            "telephone_number": "678-642-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDOUAZIN",
        "first_name": "CHERLEY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN187941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powder Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.