Active NPI
Mahlet Waregay, FNP
- Nurse Practitioner
- Woodstock, GA
National Provider Identifier
1871342089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN242296
- Practice address
- 1600 Towne Lake Pkwy
Woodstock, GA 30189-1585 - Phone
- (770) 517-1022
- NPI assigned
- May 20, 2024
- Last updated
- May 20, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN242296 | GA | Primary |
Addresses
Primary practice location
1600 Towne Lake Pkwy
Woodstock, GA 30189-1585
Mailing address
1600 Towne Lake Pkwy
Woodstock, GA 30189-1585
Phone (770) 517-1022
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Minuteclinic LLC | Nurse Practitioner | Current | Accepting new patients |
| Primary Care PLLC | Current | Accepting new patients |
Locations
11710 Alpharetta Hwy
Roswell, GA 30076
Phone (770) 754-0141
1600 Towne Lake Pkwy
Woodstock, GA 30189
Phone (678) 736-9549
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, 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": "1716163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716163200000",
"number": "1871342089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 TOWNE LAKE PKWY",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301891585",
"telephone_number": "770-517-1022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 TOWNE LAKE PKWY",
"city": "WOODSTOCK",
"state": "GA",
"postal_code": "301891585",
"telephone_number": "770-517-1022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAREGAY",
"first_name": "MAHLET",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-20",
"last_updated": "2024-05-20",
"certification_date": "2024-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "GA",
"license": "RN242296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Woodstock, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.