Active NPI
Yannique Tello, CNM
- Advanced Practice Midwife
- Riverdale, GA
National Provider Identifier
1881286185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- RN216695
- Practice address
- 81 Upper Riverdale Rd SW Ste 210
Riverdale, GA 30274-2627 - Phone
- (770) 996-1200
- NPI assigned
- Feb 8, 2021
- Last updated
- Feb 8, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | RN216695 | GA | Primary |
Addresses
Primary practice location
81 Upper Riverdale Rd SW Ste 210
Riverdale, GA 30274-2627
Mailing address
PO Box 962380
Riverdale, GA 30296-6921
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
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN216695 | GA | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| My OBGYN PC | Single Specialty | Past | 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, 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": "1612742400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612742400000",
"number": "1881286185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 962380",
"city": "RIVERDALE",
"state": "GA",
"postal_code": "302966921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "81 UPPER RIVERDALE RD SW STE 210",
"city": "RIVERDALE",
"state": "GA",
"postal_code": "302742627",
"telephone_number": "770-996-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TELLO",
"first_name": "YANNIQUE",
"credential": "CNM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-08",
"last_updated": "2021-02-08",
"certification_date": "2021-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "GA",
"license": "RN216695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverdale, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.