| Mrs Tara Phelps Gulsby, NP-C | |
|
3869 Highway 81, Loganville, GA 30052-3918 | |
| (678) 635-8650 | |
| Not Available |
| Full Name | Mrs Tara Phelps Gulsby |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 12 Years |
| Location | 3869 Highway 81, Loganville, Georgia |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568897767 | NPI | - | NPPES |
| 003143806G | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | RN209319 (Georgia) | Secondary |
| 363L00000X | Nurse Practitioner | RN209319 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Piedmont Walton Hospital | Monroe, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Piedmont Providers Llc | 9830082825 | 425 |
| Entity Name | Piedmont Providers Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1548273592 PECOS PAC ID: 9830082825 Enrollment ID: O20040204000321 |
| Entity Name | Aga, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124064118 PECOS PAC ID: 2365431350 Enrollment ID: O20040506000726 |
| Entity Name | Aga Professional Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063799120 PECOS PAC ID: 3870768997 Enrollment ID: O20111219000311 |
| Entity Name | Aga Clinical Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295193399 PECOS PAC ID: 7719273838 Enrollment ID: O20160915000872 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Tara Phelps Gulsby, NP-C 1001 Summit Blvd Ste 200, Brookhaven, GA 30319-6410 Ph: (770) 989-1668 | Mrs Tara Phelps Gulsby, NP-C 3869 Highway 81, Loganville, GA 30052-3918 Ph: (678) 635-8650 |
Gopika Naidu, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 155 Lee Byrd Road, Loganville, GA 30052 Phone: 770-466-5902 | |
Jennifer Davis, CPNP-PC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3815 Harrison Rd, Loganville, GA 30052 Phone: 770-466-6112 | |
Lori G Roberts, CPNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3815 Harrison Rd, Loganville, GA 30052 Phone: 678-527-6000 Fax: 770-466-6201 | |
Johanne Dastine-coriolan, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4344 Grove Lake St, Loganville, GA 30052 Phone: 770-696-1350 | |
Mrs. Kimberly Denise Pegues, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3869 Highway 81, Loganville, GA 30052 Phone: 678-635-8650 | |
Mrs. Amarachi Edom, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2501 Fall Creek Ldg, Loganville, GA 30052 Phone: 404-438-4634 | |
Ashley Owen, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4593 Lawrenceville Rd, Loganville, GA 30052 Phone: 770-466-8672 |