1. Home
  2. Directory
  3. Georgia
  4. Mcdonough
  5. Nurse Practitioner
  6. NPI Profile

NOBLE BOSTIC NP
NPI 1538742259
Nurse Practitioner in Mcdonough, GA

Active since April 30, 2021PECOS Enrolled
890 HUIET DR, MCDONOUGH, GA 30252(860) 881-6994 Get Directions Write a Review

NPPES record last updated: April 30, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Noble Bostic Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NOBLE BOSTIC NP (NPI 1538742259) is an individual nurse practitioner in Mcdonough, Georgia, licensed in Georgia (RN226785) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in Conyers, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1538742259
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameNOBLE BOSTICCredential: NP
Location Address890 HUIET DRMcdonough, GA 30252-8507
Mailing Address890 Huiet DrMcdonough, GA 30252-8507 · (860) 881-6994
Phone(860) 881-6994
Sole ProprietorYes
Medical School CMSOtherGraduated 2019
Enumeration DateApril 30, 2021
NPPES CertifiedApril 30, 2021
✔ NPI 1538742259 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in GA · RN226785
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
890 HUIET DR, Mcdonough, GA 30252
Open in Google Maps ↗

Secondary Practice Location 1

Location 11807 Honey Creek Cmns SEConyers, GA 30013-5837 · Phone (678) 374-2959 · Fax (404) 975-4376

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Noble Bostic Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9638636962
PECOS Enrollment IDI20260806003181
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Noble Bostic reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Breakthrough Recovery Outreach, LLC
31 mi
Substance Abuse Rehabilitation Facility
3648 CHAMBLEE TUCKER RD, SUITE F
Atlanta, GA 30341
  • Reassigned Medicare billing, Georgia enrollment
  • 5 clinicians in this Medicare group
NPI 1982909503 (770) 493-7750

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30252 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Noble Bostic's NPI number?

The NPI number for Noble Bostic is 1538742259. It was assigned to this individual provider in the NPPES registry on April 30, 2021.

Where is Noble Bostic located?

Noble Bostic practices at 890 Huiet Dr, Mcdonough, GA 30252. The listed phone number is (860) 881-6994.

What is Noble Bostic's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Noble Bostic enrolled in Medicare?

Yes. Noble Bostic is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Noble Bostic's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Noble Bostic reassigns Medicare benefits to Breakthrough Recovery Outreach, LLC (Atlanta, GA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Noble Bostic's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Noble Bostic was last updated on April 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.