Individual provider Active NPI

Kossiwa Yawli

  • Infusion Therapy Registered Nurse
  • Jonesboro, GA
National Provider Identifier
1912775263
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infusion Therapy Registered NurseTaxonomy code 163WI0500X
License
RN268783 Issued in GA
Practice address
118 North Ave Ste F
Jonesboro, GA 30236-8408
Phone
(404) 509-6192
NPI assigned
Dec 15, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infusion Therapy Registered Nurse 163WI0500X 268783 GA
Infusion Therapy Registered Nurse 163WI0500X RN268783 GA Primary

Addresses

Primary practice location

118 North Ave Ste F
Jonesboro, GA 30236-8408

Mailing address

118 North Ave Ste F
Jonesboro, GA 30236-8408
Phone (404) 509-6192

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

State licenses

LicenseStateTypeSpecialty
268783GAMDInfusion Therapy Registered Nurse
RN268783GAMDInfusion Therapy Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1912775263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 NORTH AVE STE F",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302368408",
            "telephone_number": "404-509-6192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 NORTH AVE STE F",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302368408",
            "telephone_number": "404-509-6192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAWLI",
        "first_name": "KOSSIWA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-15",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "GA",
            "license": "268783",
            "primary": false
        },
        {
            "code": "163WI0500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Infusion Therapy",
            "state": "GA",
            "license": "RN268783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.