Individual provider Active NPI

Yomarli Vargas, FNP-C

  • Family Nurse Practitioner
  • Douglasville, GA
National Provider Identifier
1902648900
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN289743 Issued in GA
Practice address
8464 Adair St
Douglasville, GA 30134-1839
Phone
(770) 949-9804
NPI assigned
Jun 10, 2024
Last updated
Jun 10, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN289743 GA Primary

Addresses

Primary practice location

8464 Adair St
Douglasville, GA 30134-1839

Mailing address

8464 Adair St
Douglasville, GA 30134-1839

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
I20240723001246 GA Practitioner - Nurse Practitioner 8729524095

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN289743GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Total Care Family Medicine PC CurrentSince Jun 1, 2024 Accepting new patients

Locations

1039 E Freeway Dr SE
Conyers, GA 30094
Phone (770) 922-0076

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": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1902648900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8464 ADAIR ST",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8464 ADAIR ST",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341839",
            "telephone_number": "770-949-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "YOMARLI",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN289743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

Verify at the official NPI Registry.