Individual provider Active NPI

Marjean Tyndale, FNP

  • Family Nurse Practitioner
  • Snellville, GA
National Provider Identifier
1992268908
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN-NP166649 Issued in GA
Practice address
2800 Lake Port Dr
Snellville, GA 30039-5452
Phone
(770) 736-1918
NPI assigned
Apr 8, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 166649 GA
Family Nurse Practitioner 363LF0000X APRN-NP166649 GA Primary

Addresses

Primary practice location

2800 Lake Port Dr
Snellville, GA 30039-5452

Mailing address

2800 Lake Port Dr
Snellville, GA 30039-5452
Phone (770) 736-1918

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
I20230330003048 GA Practitioner - Nurse Practitioner 2365817574 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstreet of Georgia PCGroup PAC ID 7517126279, 425 clinicians

Practice addresses (Care Compare)

2292 Peachtree Rd
Atlanta, GA 30309-1147
Phone (404) 382-9941

2594 Loganville Hwy
Suite 101
Grayson, GA 30017-7848
Phone (678) 369-2790

3641 Centerville Hwy
Snellville, GA 30039-6593
Phone (770) 752-4141

4763 Atlanta Hwy
Suite 420
Loganville, GA 30052-6788
Phone (404) 395-6793

Merit-based Incentive Payment System (MIPS)

Final score
19.79 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
65.96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
166649GAMDFamily Nurse Practitioner
APRN-NP166649GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstreet of Georgia PC CurrentSince Nov 26, 2024 Accepting new patients
Hardy Renew Wellness,LLC CurrentSince Dec 17, 2022 Accepting new patients

Locations

2292 Peachtree Rd NW
Atlanta, GA 30309
Phone (404) 382-9941

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1992268908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 LAKE PORT DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300395452",
            "telephone_number": "770-736-1918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 LAKE PORT DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300395452",
            "telephone_number": "770-736-1918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYNDALE",
        "first_name": "MARJEAN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "166649",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "APRN-NP166649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

Verify at the official NPI Registry.