Roseline Makinde
Individual provider Active NPI Family Nurse Practitioner · Johns Creek, GA
NPI 1902108491 · NPPES record last updated Dec 3, 2010
Key facts
- NPI
- 1902108491
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN162552 (GA)
- Practice address
- 5808 State Bridge Rd
Johns Creek, GA 30097-6476 - Phone
- (678) 495-0162
- NPI assigned
- Dec 3, 2010
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Pathways Center for Behavioral and Developmental Growth
Middle Flint Area Community Service Board
Practice addresses (Care Compare)
122 Gordon Commercial Dr
Suite C
Lagrange, GA 30240-5754
Phone (678) 854-2150
415 N Jackson St
Americus, GA 31709-3015
Phone (229) 931-2504
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110131000831 | GA | Practitioner - Nurse Practitioner | 5193904506 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN162552 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathways Center for Behavioral and Developmental Growth | Current |
Accepting new patients | |
| Pathways Center for Behavioral and Developmental Growth | Current |
Accepting new patients | |
| Middle Flint Area Community Service Board | Current |
Accepting new patients | |
| Vision Medical Consulting, P.C. | Current |
Accepting new patients | |
| Middle Flint Area Community Service Board | Current |
Accepting new patients | |
| One Stop Medical Services | Current |
Accepting new patients | |
| Middle Flint Area Community Service Board | Current | Accepting new patients | |
| The Healthcaring Clinic of Georgia, LLC | Family | Past |
Accepting new patients |
| Pathways Center for Behavioral & Developmental Growth | Past |
Accepting new patients | |
| David E Kim MD PC | Past |
Accepting new patients | |
| One Stop Medical Clinic | Past | Accepting new patients | |
| Clark Robinson, M.D.,P.C. | Past | Accepting new patients | |
| Pathways Center for Behavioral and Developmental Growth | Past | Accepting new patients |
Locations
415 N Jackson St
Americus, GA 31709
Phone (229) 815-5454
54 Peachtree Park Dr NE
Atlanta, GA 30309
Phone (404) 351-6041
3715 Northside Pkwy NW
Ste 2100
Atlanta, GA 30327
Phone (770) 938-1757
3715 Northside Pkwy NW
Bldg 2100
Atlanta, GA 30327
Phone (770) 938-1757
350 Boulevard SE
Atlanta, GA 30312
Phone (401) 688-6731
4115 Glenwood Rd
Decatur, GA 30032
Phone (404) 284-6414
2787 N Decatur Rd
Decatur, GA 30033
Phone (404) 292-0626
3311 Highway 5
Ste C
Douglasville, GA 30135
Phone (678) 383-6944
6559 Church St
Douglasville, GA 30134
Phone (770) 490-2634
4595 Cantrell Rd
Flowery Branch, GA 30542
Phone (770) 967-2070
1710 Newnan Rd
Griffin, GA 30223
Phone (770) 229-3407
122 Gordon Commercial Dr
Ste C
Lagrange, GA 30240
Phone (678) 854-2150
1109 Green St
Roswell, GA 30075
Phone (770) 998-1802
1990 Lakeside Pkwy
Ste 170
Tucker, GA 30084
Phone (770) 938-1757
4608 Lawrenceville Hwy
Tucker, GA 30084
Phone (770) 491-9444
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN162552 | GA | Yes |
Addresses
Primary practice location
5808 State Bridge Rd
Johns Creek, GA 30097-6476
Mailing address
8 Cadillac Dr
Suite 250
Brentwood, TN 37027-5087
Phone (615) 425-4287
Other providers in Johns Creek, GA
- Nelliah Mahachi
- Anuj Dinesh Mahajan
- Heather Mainard
- Melinda K. Maitland
- Ronnie Mak
- Lidiya Maksymyuk
- Rakia Tynetta Malachi
- Christopher Mallare
- Mang Plastic Surgery, LLC
- Camilla Cristina Marino
All providers in Johns Creek, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.