Individual provider Active NPI

Solomon Gezahgn Abebe

  • Psychiatric/Mental Health Nurse Practitioner
  • Lawrenceville, GA
National Provider Identifier
1003526898
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN235945 Issued in GA
Practice address
1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone
(229) 299-7476
NPI assigned
Dec 1, 2022
Last updated
Dec 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN235945 GA Primary

Addresses

Primary practice location

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694

Mailing address

3521 Kittery Dr
Snellville, GA 30039-6035
Phone (678) 755-3725

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230501002545 NC Practitioner - Nurse Practitioner 5395100119 Reassigns benefits to 2 organizations
I20230525001951 GA Practitioner - Nurse Practitioner 5395100119 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Capeside Psychiatry PLLCGroup PAC ID 5991926560, 11 clinicians
Transitions Therapeutic Care LLCGroup PAC ID 1759648470, 5 clinicians

Practice addresses (Care Compare)

102 Elizabeth St
Suite D
Jacksonville, NC 28540-5681
Phone (910) 791-6767

114 S Westgate Dr
Suite E
Greensboro, NC 27407-1686
Phone (336) 907-7308

146 Depot St
Suite 202
Blue Ridge, GA 30513-8503
Phone (910) 791-6767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN235945GAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Transitions Therapeutic Care LLC Psychiatric/Mental Health CurrentSince Nov 25, 2024 Accepting new patients
Susan K Kauffman LMHC PLLC Psychiatric/Mental Health CurrentSince May 26, 2023 Accepting new patients
Capeside Psychiatry, PLLC CurrentSince Mar 13, 2023 Accepting new patients

Locations

146 Depot St
Ste 202
Blue Ridge, GA 30513
Phone (941) 780-4192

114 S Westgate Dr
Ste E
Greensboro, NC 27407
Phone (336) 907-7308

300 S Westgate Dr
Ste A
Greensboro, NC 27407
Phone (336) 844-4684

102 Elizabeth St
Ste D
Jacksonville, NC 28540

311 Judges Rd
Ste 4E
Wilmington, NC 28405
Phone 910791676724

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1669852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1003526898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3521 KITTERY DR",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300396035",
            "telephone_number": "678-755-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MEDICAL CENTER BLVD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467694",
            "telephone_number": "229-299-7476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABEBE",
        "first_name": "SOLOMON",
        "middle_name": "GEZAHGN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "GA",
            "license": "RN235945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.