Individual provider Active NPI

Della Lertpenmaeta, CNP

  • Nurse Practitioner
  • Powder Springs, GA
National Provider Identifier
1912997206
Registry record updated Dec 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN093485 Issued in GA
Practice address
4250 Brownsville Rd
Powder Springs, GA 30127-2559
Phone
(678) 567-8000
Fax
(770) 439-3555
NPI assigned
Oct 27, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN093485 GA Primary

Addresses

Primary practice location

4250 Brownsville Rd
Powder Springs, GA 30127-2559

Mailing address

4250 Brownsville Rd
Powder Springs, GA 30127-2559
Phone (770) 920-2280

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)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Douglas County Family Practice, P.C. PastSince Sep 25, 2017 Accepting new patients
Wellstar Medical Group, LLC Past Accepting new patients
Douglas County Family Practice, P.C. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388102400000",
    "number": "1912997206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 BROWNSVILLE RD",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301272559",
            "telephone_number": "770-920-2280",
            "fax_number": "770-439-3555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 BROWNSVILLE RD",
            "city": "POWDER SPRINGS",
            "state": "GA",
            "postal_code": "301272559",
            "telephone_number": "678-567-8000",
            "fax_number": "770-439-3555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LERTPENMAETA",
        "first_name": "DELLA",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2013-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN093485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Powder Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2013; 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.