Individual provider Active NPI

Maxine Rockhead, FNP

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1982057469
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN191053 Issued in GA
Practice address
1263 Moreland Ave SE
Atlanta, GA 30316-3183
Phone
(470) 444-3137
Fax
(470) 202-3003
NPI assigned
Jul 19, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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 RN191053 GA Primary

Addresses

Primary practice location

1263 Moreland Ave SE
Atlanta, GA 30316-3183

Mailing address

PO Box 746063
Atlanta, GA 30374-6063
Phone (866) 464-0875

Other practice location 1

5332 Salem Springs Pl
Lithonia, GA 30038-4850
Phone (770) 323-5161

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
I20251113004586 GA Practitioner - Nurse Practitioner 9931690385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oak Street Health of Georgia PCGroup PAC ID 0345658647, 37 clinicians

Practice addresses (Care Compare)

1263 Moreland Ave SE
Atlanta, GA 30316-3183
Phone (470) 444-3137

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN191053GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oak Street Health of Georgia PC Family CurrentSince Oct 27, 2025 Accepting new patients
Qcpi-Villagemd, PC Past Accepting new patients

Locations

1263 Moreland Ave SE
Atlanta, GA 30316
Phone (470) 444-3137

1825 Rockbridge Rd
Ste 15B
Stone Mtn, GA 30087
Phone (470) 444-3134

Organizations & group practices 2

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": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1982057469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746063",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746063",
            "telephone_number": "866-464-0875",
            "fax_number": "312-929-0373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1263 MORELAND AVE SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303163183",
            "telephone_number": "470-444-3137",
            "fax_number": "470-202-3003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5332 Salem Springs Pl",
            "address_purpose": "LOCATION",
            "city": "Lithonia",
            "state": "GA",
            "postal_code": "300384850",
            "country_code": "US",
            "telephone_number": "770-323-5161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROCKHEAD",
        "first_name": "MAXINE",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN191053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.