MS. JUDITH T CHABOT (FNP-C) – Family Nurse Practitioner, NPI 1063419216

MS. JUDITH T CHABOT (FNP-C) is a healthcare provider. based in Conyers, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. F0803368 (GA). The NPI Number for MS. JUDITH T CHABOT (FNP-C) is 1063419216

Main info

Female
Sole Proprietor
23 Years Of Experience
Accepts Medicare Assignment
Name
MS. JUDITH T CHABOT (FNP-C)
NPI
1063419216
Phone
(770) 484-5423
Address
2062 LAKE SORRENTO DR
Enumeration Date
1 July 2005
Last Update Date
11 March 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4048811155
Graduation Year
2003 (23 years ago)
PAC ID
9234290826
Group Practice PAC ID
9739260019
Professional Enrollment ID
I20081201000388
Address ID
GA303081934AT688XXNWXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

9,652 NURSE PRACTITIONER in GA

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Provider Addresses for MS. JUDITH T CHABOT (FNP-C)

  • 2062 LAKE SORRENTO DR

    CONYERS, GA 300122739

    Phone: (770) 484-5423

    Fax: (678) 413-2030

    Type: Mailing

  • 425, Sigman Road Northwest, Conyers, Rockdale County, Georgia, 30012, United States

    SUITE 109

    CONYERS, GA 300123635

    Phone: (678) 413-2026

    Fax: (678) 413-2030

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2008-12-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20081201000388INurse PractitionerGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30012)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9739260019View full group profile

Reviews

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Frequently asked questions

How do I look up MS. JUDITH T CHABOT (FNP-C) by NPI?
Use NPI 1063419216 when you need to reference MS. JUDITH T CHABOT (FNP-C) in forms, claims, or directories.
Is MS. JUDITH T CHABOT (FNP-C) active in the national directory?
MS. JUDITH T CHABOT (FNP-C)'s public NPI profile is in an active state.
What kind of provider is MS. JUDITH T CHABOT (FNP-C)?
The page reflects Family Nurse Practitioner for MS. JUDITH T CHABOT (FNP-C). Clinical services aligned with this taxonomy classification.
Where does public data place MS. JUDITH T CHABOT (FNP-C)?
The snapshot lists Conyers, Georgia for MS. JUDITH T CHABOT (FNP-C); download NPPES for the complete set.
What if Conyers, Georgia seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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