Paola Pantaleon, FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN216518 Issued in GA

Practice address

3790 Holcomb Bridge Rd
Peachtree Corners, GA 30092-4801

Phone

(470) 545-0305

NPI assigned

Sep 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1992310205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5068 NEWPARK DR NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301017100",
            "telephone_number": "678-520-7414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3790 HOLCOMB BRIDGE RD",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300924801",
            "telephone_number": "470-545-0305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTALEON",
        "first_name": "PAOLA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN216518",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE NURSE PRACTITIONER LICENSE NUMBER",
            "identifier": "RN216518",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand/Da",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "ADDRESS",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ADDRESS",
            "address_1": "5068 Newpark Dr NW",
            "city": "Acworth",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301017100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Nurse Practitioner in Peachtree Corners, GA
• Providers in Peachtree Corners, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; 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.