NPI age
10 years
Enumerated 2015-11-16
● Active Type 2 · Organization
363l00000x
363l00000x is 1 of 35 nursing facility/intermediate care facility organizations in Georgia.
Primary specialty
Nursing Facility/Intermediate Care Facility
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Peterson
Nurse Practitioner
Last NPPES update
2015-11-16
Source: monthly bulk 2026-05
How this organization compares
Across 35 active nursing facility/intermediate care facility providers in Georgia.
NPI age
10 years
↓ 4 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2015 → 2026
2015-11Enumerated in NPPES
2015
2026
Where they practice
Primary practice location
2171 Peachtree Rd Ne, Apt 306
Atlanta, GA 303096300
Mailing address
2171 Peachtree Rd Ne, Apt 306
Atlanta, GA 303096300
Authorized official
Anetha Deborah Peterson
Nurse Practitioner
📞 6784649424
Specialties
-
Nursing Facility/Intermediate Care Facility PrimaryAn institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation...
Practice context
Single-site organization. Only one practice location on file.
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Request a quote →How to verify this organization
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.